The ROSES Study
Research type
Research Study
Full title
The role of self-surveillance and appearance anxiety as mediators of the relationship between self-objectification and sexual functioning in individuals with sexual pain – a case-control study.
IRAS ID
334437
Contact name
Susannah Jenner
Contact email
Sponsor organisation
University of Oxford / Research Governance, Ethics and Assurance
Duration of Study in the UK
1 years, 6 months, 30 days
Research summary
Research Summary: Vaginismus, dyspareunia, and vulvodynia/vestibulodynia are female sexual pain conditions which can involve pain before, during, or after sex, or generalised pain in the genital area. Individuals with these conditions may benefit from psychological treatment.
Researchers wonder whether individuals with sexual pain may struggle with their body image, which means that they may have difficulty with their appearance and accepting the way they look. This could include experiencing shame or anxiety around one’s looks, and therefore constantly monitoring one’s own appearance. It may also mean seeing oneself from the perspective of other people. This may lead to distress, potential mental health problems and further sexual pain, resulting in a vicious cycle of self-objectifying, body monitoring, and anxious thoughts. The aforementioned factors are part of the so-called Self-objectification Theory which we would like to put to the test in this study (Fredrickson & Roberts, 1997).
This study will look at two groups of participants:
1) individuals with vaginismus, dyspareunia, and/or vulvodynia/vestibulodynia
and
2) individuals without any of these sexual pain conditions.Participants will fill in an online survey which will ask about self-objectification, self-surveillance, appearance anxiety, and sexual functioning.
We would like to find out if individuals who experience sexual pain place more emphasis on their looks and monitor how they may appear to others.
We also aim to explore whether these individuals have higher levels of anxiety around their appearance. Further, we will explore how these different factors interact with one another.This is the first study to test Self-Objectification Theory in individuals who experience sexual pain.
Previous studies have investigated self-objectification in healthy individuals only.This may help us develop better treatments for individuals with sexual pain.
This study is funded by the Oxford Clinical Psychology Training course.Summary of results:
What did we study and why? Some women experience persistent pain during sexual touch and sexual penetration, even when no clear medical cause is found. Conditions like vaginismus, dyspareunia, and vulvodynia can be distressing and often require support from different types of healthcare professionals, such as medical doctors, physiotherapists, and psychologists. Psychological approaches often focus on helping women gradually become more comfortable with sensations or activities that have become linked to fear or pain, and these methods have shown success. However, research in this area is still limited. There is relatively little understanding of how factors like sexual identity and body image may influence the experience of pain or the effectiveness of treatment.What were our aims? In this study, we wanted to explore whether concerns about body image play a role in persistent sexual pain in women. We looked at whether women with these conditions tend to focus more on how their bodies appear to others, monitor their appearance more closely, and feel more anxious about how they look compared to women without these conditions. If these factors are linked to sexual pain, this could help guide new treatment approaches that address body image alongside other forms of support.
What did we do? This study included 125 women: 60 who experience persistent sexual pain and 65 without sexual pain. They completed an online survey including questions about body image, including how much they focus on their appearance, worry about how they look, and their sexual experiences. We compared the two groups and explored whether body image concerns might help explain differences in sexual well-being and levels of pain and anxiety. Someone with lived experience of psychosexual pain was actively involved in shaping the research. They reviewed and helped to create all participant-facing materials to ensure the language was clear, the content was accessible, and the questions were appropriate. They also tested the survey, provided feedback, and highlighted any barriers for participants. Their input also guided how the findings were shared more widely.
What did we find out? Women with persistent sexual pain were more likely to judge themselves based on their physical appearance rather than their health and physical competence, compared to those without pain. However, they were not more likely to closely monitor how they look or feel anxious about their appearance. Further analysis showed that feeling anxious about one’s appearance helped explain the link between focusing on appearance and difficulties with sexual well-being.
The study had some limitations. Although our control group had no history of sexual pain, many experienced other difficulties. Around 68% showed signs of depression, 35% showed signs of anxiety, and 40% had experienced sexual abuse or assault. These rates were higher than those found in the general population. There were no significant differences between the sexual pain group and the controls in terms of depression, anxiety, mental health medication, or past sexual trauma. This is notable given ongoing debates about the role of sexual trauma in the development of sexual pain. While both groups had higher rates of lifetime sexual trauma than the general population, sexual abuse was not more common in those with sexual pain.
How is this relevant? These findings suggest that worrying about one’s appearance may play a key role in sexual difficulties and persistent sexual pain. Future treatments could benefit from incorporating mindfulness, and body-focused techniques to help reduce self-consciousness during intimacy and ease distress related to body image. Research should also explore therapies that target these psychological factors, rather than mainly focusing on physical and mechanical aspects of sexual function.
We aim to submit this study as a paper to the Journal of Sex and Marital Therapy in September. The journal has an established record of publishing original research regarding sexual dysfunctions and psychological theory informing treatment modalities in psychosexual and marital therapy.
REC name
South Central - Oxford B Research Ethics Committee
REC reference
24/SC/0178
Date of REC Opinion
16 Jul 2024
REC opinion
Further Information Favourable Opinion