Both sexual dysfunction and low sexual satisfaction occur in a large percentage of people with MS (McCabe et al., 2003
; Miller et al., 1994
), yet, research on factors influencing sexual satisfaction among this population is extremely limited. The present study investigated the extent to which changes in perceived partner support were associated with sexual satisfaction among those with MS. Results indicated that changes in perceived social support received from one's partner was related to sexual satisfaction, specifically, increases in positive social support and decreases in negative partner support were associated with improved sexual satisfaction over the course of this study. Even after controlling for changes in depression brought about by treatment, individuals who reported increases in positive partner support and decreases in negative partner support endorsed significantly improved sexual satisfaction.
The current findings are consistent with past research that negative social support can be detrimental to individuals, while positive partner support often leads to improved outcomes. For example, in a longitudinal study of community-dwelling older adults, increases in negative social support were associated with rising rates of disability. In contrast, high levels of positive support were associated with lower disability rates (Mavandadi et al., 2007
). Evidence for the importance of type of social support in predicting well-being and distress level was also reported in research by Newsom et al., (2005)
; positive social support was associated with greater well-being in a national sample of older adults. Meanwhile, negative social exchanges were associated with poorer well-being and more distress. The role of social support in predicting psychological outcomes in populations living with MS has also been investigated. Support has been found for the impact of negative and positive social support on stress level, specifically, negative partner support served to increase perceived stress, but positive partner support reduced the detrimental impact of this negative social support on stress (Kleiboer, et al., 2007
). Negative forms of partner social support have also been associated with increased disability, and worse physical and mental health among those with MS (Schwartz & Kraft, 1999
). However, the current study is the first to our knowledge to investigate the role of positive and
negative partner support on the outcome of sexual satisfaction among those with MS.
Our results suggest that indeed, for individuals living with MS, both positive and negative partner support have a distinctive role in the outcome of sexual satisfaction. Similar to other samples of people with MS, approximately 73% of our sample reported sexual dysfunction (Kessler et al., 2009
). The association of increased positive partner support and decreased negative partner support with sexual satisfaction was significant even after controlling for sexual dysfunction, age, gender, and depression level. Although scant data are available on partner support and sexual satisfaction in those with MS, our data are consonant with other studies showing increased social support is associated with better sexual satisfaction in a general community sample (Ojanlatva, 2005). These findings are also consistent with other research among participants with chronic illness, which has found greater perceived partner support to be associated with sexual satisfaction in people with rheumatoid arthritis (van Lankveld et al., 2004
). In addition, a study of couples with MS found that greater perceptions of support from one's partner (i.e., amount of physical and emotional support, intimacy, and understanding from one's partner) were correlated with higher sexual satisfaction (McCabe & McDonald, 2007
We note several limitations to the current study. As with all other self-report studies, our data may be influenced by factors such as self-report bias. Moreover, our findings only generalize to those in a coupled, sexually active relationship who agreed to complete a measure of sexual satisfaction. Past research has found that those who take part in studies on sexuality have been found to have more liberal attitudes and more sexual experience than those who do not (Wiederman, 1999
). In addition, our analyses showed those eligible (vs. not) for this study had a higher percentage of people reporting sexual dysfunction, but our measurement of sexual dysfunction contained only one item. The results should be replicated with more detailed measures of sexual functioning in the future. On a final note, because these participants were taking part in an RCT of psychotherapy for depression these results may not be generalizable to populations with MS who are not depressed and are not receiving treatment for depression.
Health care providers and professionals need to be aware of high rates of sexual dysfunction and low levels of sexual satisfaction among MS populations (Kessler et al., 2009
; McCabe et al., 2003
). Although sexual dysfunction is one factor shown to be associated with lower sexual satisfaction (McCabe, & McDonald, 2007
), data from this study suggest that sexual satisfaction can also be influenced by relationship variables. Other research underscores this point. For example, among a community sample of individuals with MS who were more satisfied with their relationship also had more positive appraisals about their sex life (McCabe, McDonald, Deeks, Vowels, & Cobain, 1996
). Likewise, a qualitative study on couples living with MS found couples reporting stronger communication also had improved appraisals of their sex life (Esmail, Munro, & Gibson, 2007
Clinicians should note that strengthening relationship satisfaction and communication among couples may positively influence levels of sexual satisfaction. While this relationship needs further investigation, interventions for couples living with MS aimed at improving the overall quality of partner support may be one promising direction. Future studies might also examine dyadic data to better understand the partner's viewpoint of the interaction and how partners mutually influence one another's sexual satisfaction. In conclusion, sexual dysfunction in MS is due in large part to physiological effects of the illness (Zivadinov et al., 1999
) while sexual satisfaction is a more subjective experience and therefore, may be more amenable to psychosocial interventions. Understanding the unique role of positive and negative forms of partner support on sexual satisfaction will help lead to future interventions to improve sexual satisfaction among couples through bolstering positive partner support.