Medical Journal of Mashhad university of Medical Sciences

Medical Journal of Mashhad university of Medical Sciences

The Mediating Role of Anxiety Sensitivity and Sleep Quality in the Relationship Between Symptoms of Premenstrual Dysphoric Disorder and Sexual Dysfunction In Married Women

Document Type : Research Paper

Authors
nazanin fatehi
Mohsen Kachooei
fatemeh joharifard
Department of Psychology, Humanities Faculty, University of Science and Culture, Tehran, Iran.
10.22038/mjms.2024.79738.4590
Abstract
Introduction:Sexual dysfunction is associated with many important and significant harms in different areas of marital functioning.Therefore, any effort to improve the level of physical and psychological health of women is necessary and valuable. Therefore, the aim of this research is to examine the mediating role of anxiety sensitivity and sleep quality in the relationship between Premenstrual Dysphoric Disorder and sexual dysfunction.
Materials and methods:The research method was descriptive and fundamental in nature.The research sample consisted of 373 married women living in Tehran who were selected through accessible sampling method in 2023.Data were collected using questionnaires including Female's sexual function (Rosen et al's ;2000), premenstrual symptoms screening (Steiner et al's ;2003),sleep quality assessment (Boyce et al's; 1989) and anxiety sensitivity (Taylor et al's ;2007).Data were analysed using Pearson correlation and path analysis.
Results: According to the results of the path analysis, it was observed that the direct effect of Premenstrual Dysphoric Disorder on sexual dysfunction was positive and significant (p=0.004; β=0.157).In addition, the indirect effect of Premenstrual Dysphoric Disorder on sexual dysfunction through both sleep quality and anxiety sensitivity was positive and significant(β=0.027, p=0.030, , β=0.072, p=0.001 respectively).Therefore, the variables of sleep quality and anxiety sensitivity played a partial mediating role in the relationship between Premenstrual Dysphoric Disorder and sexual dysfunction.
Conclusion:The results of the present research can help researchers and therapists in the field of mental health in two ways:1.theoretical(extending and enriching theoretical concepts in the field of couple therapy) 2. operational (designing educational programmes for prevention, screening and treatment)
Keywords
Keywords: Premenstrual Dysphoric Disorder
Sexual Dysfunction
Anxiety Sensitivity
Sleep Quality
Married wome
Subjects
  1. Panahi, R., Anbari, M., Javanmardi, E., Ghoozlu, K. J., & Dehghankar, L. The effect of women’s sexual functioning on quality of their sexual life. Journal of preventive medicine and hygiene. 2021;62(3), E776.

 

  1. ‏ Susser, L. C., Parish, S., Dumas, E., & Nappi, R. E. Premenstrual dysphoric disorder and sexual function: a narrative review. Sexual Medicine Reviews.2023; 11(3), 202-211.‏

 

  1. Shoaa Kazemi, M., Alikhani Shateri, F., & Mohammadi, F. (2022). Marital boredom and sexual dysfunction in women with breast cancer. Journal of Family Relations Studies.2022; 2(7), 29-36.‏

 

  1. İlhan, G., Verit Atmaca, F. V., Kurek Eken, M., & Akyol, H. (2017). Premenstrual syndrome is associated with a higher frequency of female sexual difficulty and sexual distress. Journal of sex & marital therapy.2017; 43(8), 811-821.‏

 

  1. Nussbaum, A. M. The pocket guide to the DSM-5-TR™ diagnostic exam. American Psychiatric Pub. 2022‏

 

  1. Li, Z., Xu, M. J., Jin, Y., & Zhu, B. G. Premenstrual dysphoric disorder is associated with the longer length from clitoris to urethra. BMC Women's Health. 2021; 21, 1-5.‏

 

  1. Elazar, A. B., Canetti, L., Azoulay, M., Dan, R., Goelman, G., Segman, R., ... & Reuveni, I. Quality of Life among University Students with Premenstrual Symptoms: The Role of Emotion Regulation. European Psychiatry.2023; 66(S1), S648-S649.‏

 

  1. Dogu S, ekici çağlar G, ekici B. Comparison of Mood, Physical Symptoms, Cognitive Failure and Life Satisfaction in Women with Premenstrual Dysphoric Disorder, Premenstrual Syndrome and No/Mild Premenstrual Syndrome: A Controlled Study. Bezmialem Science. 2022;10(5).

 

  1. Eccles, H., & Sharma, V.The association between premenstrual dysphoric disorder and depression: A systematic review. Journal of Affective Disorders Reports. 2023; 12, 100504.‏

 

  1. Olthuis, J. V., Connell, E. M., O’Sullivan, L. F., & Byers, E. S. Does anxiety sensitivity interfere with sexual well-being? Evidence from a community sample. Sexual and Relationship Therapy.2023; 1-17.‏

 

  1. Byers, E. S., Olthuis, J. V., O’Sullivan, L. F., & Connell, E. M. Anxiety sensitivity in the sexual context: Links between sexual anxiety sensitivity and sexual well-being. Journal of sex & marital therapy.2023; 49(5), 550-562.‏

 

  1. Taylor, S., Zvolensky, M. J., Cox, B. J., Deacon, B., Heimberg, R. G., Ledley, D. R., ... & Cardenas, S. J. (2007). Robust dimensions of anxiety sensitivity: development and initial validation of the Anxiety Sensitivity Index-3. Psychological assessment.2007; 19(2), 176-88.

 

  1. Guo Y, Yang H, Elhai J, McKay D. Anxiety regarding COVID-19 is related to attentional control: the mediating role of anxiety sensitivity. Frontiers in Psychiatry.2021;12(1):713279.

 

  1. Bakhshipour, A., Sadeghi, A., & Hosseini, F. Modeling marital conflicts based on alexithymia with the mediating role of anxiety sensitivity and sexual dissatisfaction in married female students at University of Guilan. Journal of Family Relations Studies.2024; 4(12), 15-25.‏

 

  1. Li, S., & Li, X. The relationship between attentional bias, anxiety sensitivity, and depression and anxiety symptoms: evidence from the COVID-19 Pandemic in China. Frontiers in Public Health.2022; 10, 832819.‏

 

  1. Tutino, J. S., Ouimet, A. J., & Shaughnessy, K. (2017). How do psychological risk factors predict sexual outcomes? A comparison of four models of young women’s sexual outcomes. The journal of sexual medicine.2017; 14(10), 1232-1240.‏

 

  1. Sarchami, R., Koshki, S., Jamali, B., & Baghdasarians, A. (2022). Structural Model of Cognitive Emotion Regulation Based on Sleep Quality with Mediating Role of Marital Satisfaction in Women with Premenstrual Syndrome. Journal of Sabzevar University of Medical Sciences.2022; 29(4), 576-590.‏

 

  1. Kling, J. M., Kapoor, E., Mara, K., & Faubion, S. S. Associations of sleep and female sexual function: good sleep quality matters. 2021;28(6), 619-625.‏

 

  1. Martínez Vázquez, S., Hernández Martínez, A., Peinado Molina, R. A., & Martínez Galiano, J. M. (2023). Association between sexual function in women and sleep quality. Frontiers in Medicine.2023; 10, 1196540.‏

 

  1. Afsahri, P., Salehnejad, Z., Hekmat, K., Abedi, P., Fakhri, A., & Haghighizadeh, M. Do Sleeping Disorders Impair Sexual Function in Married Iranian Women of Reproductive Age? Results from a Cross-Sectional Study. Psychiatry journal. 2018

 

  1. Önay, Ö., & Aydın, C. Premenstrual syndrome as a sleep disturbing factor: a cross-sectional study. Acta Medica.2021; 52(2), 145-151.‏

 

 

  1. Jadhav, A., Chaudhury, S., & Saldanha, D. A study of prevalence and psychological correlates of premenstrual syndrome and premenstrual dysphoric disorder. Medical Journal of Dr. DY Patil University.2022; 15(6), 895-905.

‏

  1. Madsen, J. W., Hernández, L., Sedov, I., & Tomfohr-Madsen, L. M. Romantic relationship satisfaction is associated with sleep in undergraduate students. Couple and Family Psychology: Research and Practice.2023; 12(1), 39.‏

 

  1. Kline, R. B. Principles and practice of structural equation modeling. Guilford publications.‏

New York.2016 (4th ed.).

 

  1. Rosen, C. Brown, J. Heiman, S. Leiblum, C. Meston, R. Shabsigh, D. Ferguson, R. D'Agostino, R. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. Journal of sex & marital therapy.2000; 26(2), 191-208.‏

 

  1. Mohammadi, KH, Heydari, M, Faghihzadeh, S. The female sexual function index (Fsfi): Validation of the iranian version. PAYESH. 2008;7(3):269-78.

 

  1. Steiner M, Macdougall M, Brown E. The premenstrual symptoms screening tool (PSST) for clinicians. Arch Womens Ment Health. 2003;6(3):203-9.

 

  1. Siahbazi, sh, Hariri, F , Montazeri, A, Moghaddam, l. Translation and psychometric properties of the Iranian version of the Premenstrual Symptoms Screening Tool (PSST). Payesh (Health Monitor) Journal. 2011;10(4):421-7.

 

  1. Foroughi AA, Mohammadpour M, Khanjani S, Pouyanfard S, Dorouie N, Parvizi Fard A. Psychometric properties of the Iranian version of the Anxiety Sensitivity Index-3 (ASI-3). Trends Psychiatry Psychother.2019; 41(3):254-61.

 

  1. Buysse, D. J., Reynolds III, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry research.1989; 28(2), 193-213.

 

  1. Farrahi Moghaddam, J., Nakhaee, N., Sheibani, V., Garrusi, B., & Amirkafi, A. Reliability and validity of the Persian version of the Pittsburgh Sleep Quality Index (PSQI-P). Sleep and Breathing.2012; 16, 79-82.‏

 

  1. Coolidge FL. Statistics: A gentle introduction (2nd ed). Thousand Oaks, CA: Sage. 2006.

 

 

  1. Byrne, B. M. Structural equation modeling with AMOS: Basic concepts, applications, and programming (3rd ed). New York: Routledge. 2016

 

  1. Kenny DA, Kaniskan, B., & McCoach, D. B. The performance of RMSEA in models with small degrees of freedom. Sociological methods & research. 2015;3(44):486-507.

 

  1. Nitzl C, Roldan JL, Cepeda G. Mediation analysis in partial least squares path modeling. Industrial Management & Data Systems. 2016;116(9):1849-64.

 

  1. Eissa, M. F., Missiry, M. A., Kamel, K. F. W., & Mahmoud, D. A. M. Sexual dysfunction and quality of life in female patients with major depression disorder. Middle East Current Psychiatry.2022; 29(1), 43.‏
  2. Van Lonkhuijzen, R. M., Garcia, F. K., & Wagemakers, A. (2023). The stigma surrounding menstruation: Attitudes and practices regarding menstruation and sexual activity during menstruation. Women's Reproductive Health.2023, 10(3), 364-384.‏

 

  1. Meers, J. M., & Nowakowski, S. Sleep, premenstrual mood disorder, and women’s health. Current opinion in psychology.2020; 34, 43-49.‏

 

  1. Kleinstäuber, M., Schmelzer, K., Ditzen, B., Andersson, G., Hiller, W., & Weise, C. Psychosocial profile of women with premenstrual syndrome and healthy controls: a comparative study. International journal of behavioral medicine.2016; 23, 752-763.‏
  2. Joki Perdani S, Rezki Perdani S, Mahirah M, Abdul Rashid Abdul A. sustaining long-distance relationship through love, trust, and dedication among married couples. manu Jurnal Pusat Penataran Ilmu dan Bahasa. 2023;34(1):63 - 80.
  3. Morssinkhof, M. W. L., Van Wylick, D. W., Priester-Vink, S., Van Der Werf, Y. D., Den Heijer, M., Van Den Heuvel, O. A., & Broekman, B. F. P. Associations between sex hormones, sleep problems and depression: A systematic review. Neuroscience & Biobehavioral Reviews.2020; 118, 669-680

 

  1. Meers, J. M., & Nowakowski, S. Sleep, premenstrual mood disorder, and women’s health. Current opinion in psychology.2020; 34, 43-49.‏

 

  1. Uğur k, yildiz s, kazğan a, kurt o, Atmaca M. Premenstrual disforik bozukluk tanılı hastaların kişilik özellikleri, anksiyete duyarlılığı, anksiyete ve depresyon seviyeleri. Cukurova Medical Journal. 2021;46(4):1360-8.
  2. Bagheri Sheikhangfesheh F, Hojjatolah,F. The role of emotional ataxia, anxiety sensitivity and pain anxiety in predicting couples' sexual performance. 4th National Congress of Family Psychology Association of Iran Successful Marriage and Healthy Parenting. 1401
  3. Lamont, J. M. Trait body shame predicts menstrual-related symptoms: evidence for extending the menstrual reactivity hypothesis. Women's Reproductive Health.2023; 10(1), 24-42.
  4. Kane, L., Dawson, S. J., Shaughnessy, K., Reissing, E. D., Ouimet, A. J., & Ashbaugh, A. R. A review of experimental research on anxiety and sexual arousal: Implications for the treatment of sexual dysfunction using cognitive behavioral therapy. Journal of Experimental Psychopathology.2019;10(2).‏
Medical Journal of Mashhad university of Medical Sciences
Volume 67, Issue 5 - Serial Number 5
September and October 2024
Pages 41-55