Self-efficacy as a relevant construct in understanding sexual response and dysfunction
Abstract
While self-efficacy has been widely used to explain and treat various biobehavioral responses, few investigations have examined this concept in the context of sexual response and dysfunction. In this study, the authors constructed a measure of sexual self-efficacy, investigated whether it differentiated men with and without sexual dysfunction, and determined the utility of this construct by exploring its relation to other variables known to be related to erectile dysfunction in a sample of 60 men with erectile dysfunction and 14 functional men visiting a urology clinic. The sexual self-efficacy index differentiated men with and without erectile dysfunction, and general linear modeling showed that the index did indeed relate to other variables known to affect sexual and emotional response during a partnered sexual experience. These findings suggest that, as a unifying construct that predicts cognitive, affective, motivational, and behavioral responses, sexual self-efficacy has the potential to play an important role in the assessment of effective treatments for sexual problems.
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Men with ED tend to attribute the erectile failure to their own incompetence (internal attribution) and experience a lower sense of control or self-efficacy.
“Men with ED tend to attribute the erectile failure to their own incompetence (internal attribution) and experience a lower sense of control or self-efficacy.20,30,31”
From A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM) (2021) · cites this paper as [30]
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BackgroundSelf-citationSexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review
Rahmani, A., Afsharnia, E., Fedotova, J., Shahbazi, S., Fallahi, A., Allahqoli, L., Gheshlagh, R. G., Abboud, S., & Alkatout, İ. (2022) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2022.03.614 · Cited by 29 · see citing works
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“…having the potential to exacerbate the dysfunctional response by reducing the individual’s overall sense of self-efficacy (Alloy et al., 2006; Aubin & Heiman, 2004; Rowland et al., 2015), thereby placing further stress on the relationship (Nobre& Pinto-Gouveia, 2009; Stephenson & Meston, 2016).”
BackgroundTypologies of Women with Orgasmic Difficulty and Their Relationship to Sexual Distress
Hevesi, K., Miklós, E., Horváth, Z., Sal, D., & Rowland, D. L. (2020) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2020.02.008 · Cited by 14 · see citing works
Rowland, D. L., Dabbs, C. R., & Medina, M. (2018) · Archives of Sexual Behavior · doi:10.1007/s10508-018-1270-z · Cited by 14 · see citing works
Prevalence of Premature Ejaculation: A Narrative Review of National and Cultural Differences
Tamas, S., Mirnics, Z., Hevesi, K., & Rowland, D. L. (2024) · Sexes · doi:10.3390/sexes5040043 · Cited by 13 · see citing works
“Furthermore, both meth-ods (using professional definitions or validated PROs) typically assess both ejaculatory control—the primary defining criteria for PE [9,12,14,87]—and bother/distress [78].”
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Rowland, D. L., Kostelyk, K. A., & Tempel, A. R. (2016) · Sexual and Relationship Therapy · doi:10.1080/14681994.2015.1126669 · Cited by 10 · see citing works
“Such general cognitive frameworks are highly counterproductive, having the potential to exacerbate the dysfunctional response by reducing the man’s sense of self-efficacy (Rowland et al., 2015), thereby placing further stress on the relationship and possibly interfering with effective treatment strategies (Nobre & Pin…”
BackgroundMethodResultInfluentialBorgmann, M., Brandner, L. M., Durso, D. D., Gonin-Spahni, S., Znoj, H., & Werner, M. A. (2023) · The Journal of Sex Research · doi:10.1080/00224499.2023.2261439 · Cited by 11 · see citing works
“…Self-Efficacy & Pleasure-Related Mastery and Enjoyment-Related Self-Worth & Pleasure-Related Validation scales showed differential patterns of relationships with Sexual Assertiveness and Self-Esteem, supporting their intended interpretation (Mastro & Zimmer-Gembeck, 2015; Rowland et al., 2015).”
Attribution Patterns in Men Who Ejaculate Before They Desire: An Internet Survey
Rowland, D. L., Mikolajczyk, L. C., Pinkston, D. M., Reed, H. M., & Lo, D. M. (2015) · Journal of Sex & Marital Therapy · doi:10.1080/0092623x.2015.1069432 · Cited by 10 · see citing works
“…frameworks, while consisting of both accurate and false assumptions, may exacerbate the dysfunctional response by reducing the man’s sense of self-efficacy (Rowland et al., 2015), place stress on the relationship, and interfere with effective treatment strategies (Nobre & Pinto-Gouveia, 2009).”
BackgroundPredicting Anxiety and Depression Among Erectile Dysfunction Patients: A Cross-Sectional Study
Nguyen, Q., Trường, L. V., Chung, E., Quang, B. V., Long, L. Q., Ngọc, N. T., Minh, N. A., Anh, D. M., Thành, N. Đ., & Nam, N. T. (2024) · American Journal of Men s Health · doi:10.1177/15579883231223502 · Cited by 9 · see citing works
“Men with ED often attribute the erectile failures to personal incompetence (internal attri-bution) and perceive a lower sense of control or self-efficacy (Rowland et al., 2015).”
BackgroundKhazaeian, S., Navidian, A., & Rahimi-Nezhad, M. (2023) · Sexual Medicine · doi:10.1093/sexmed/qfad031 · Cited by 8 · see citing works
Zadeh, Z. F., Bhutto, Z. H., McNabney, S. M., Kneusel, J. A., & Rowland, D. L. (2021) · International Journal of Sexual Health · doi:10.1080/19317611.2020.1864559 · Cited by 8 · see citing works
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“37,38 Other dispositional factors linked to sexual performance anxiety include socially and culturally derived sexual beliefs/myths (eg, macho beliefs, submission beliefs); maladaptive sexual schemas (eg, “I’m helpless” or “I’m not good at this”); and negative automatic thoughts (or self-talk)…”
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“According to Rowland (2015), positive sexual self-concept, including sexual self-efficacy, is strongly associated with sexual function.29,30,9 Menopausal women in our study tend to not refuse their husband’s request for sexual intercourse.”
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“…and high levels of learned helplessness could predict depression in individuals with SCI. Similarly, sexual self-efficacy is crucial for proper and desirable sexual functioning (Willoughby et al., 2014) which, in turn, is related to a better mental and social performance (Sadock & Kaplan, 2009).”
BackgroundKong, L. V., Goh, P. H., & Ting, R. S. (2022) · Psychology and Sexuality · doi:10.1080/19419899.2022.2053564 · Cited by 5 · see citing works
“While the idea of the role of self-liking in sexual functioning has not been widely studied, self-efficacy being a closely related concept to self-competence (Tafarodi & Swann, 2001) has been found to be positively associated with sexual function (Atrian et al., 2019; Rowland et al., 2015).”
BackgroundResultBhutto, Z. H., Zadeh, Z. F., Shahab, A., & Rowland, D. L. (2020) · Women & Health · doi:10.1080/03630242.2020.1824955 · Cited by 5 · see citing works
Banbury, S. A., Moneta, G. B., & Chandler, C. (2021) · Sexual & Relationship Therapy · doi:10.1080/14681994.2021.1932796 · Cited by 4 · see citing works
“For example, regarding self-efficacy and anxiety, those who do not feel they can manage anxiety provoking events/triggers might result in heightened anxiety arousal (Bandura, 2007) which can impact sexual functioning (Rowland et al, 2015).”
BackgroundRowland, D. L., McNabney, S. M., Attinger, D. R., Harrold, K. J., Kövi, Z., & Hevesi, K. (2023) · International Journal of Impotence Research · doi:10.1038/s41443-023-00752-y · Cited by 4 · see citing works
Rowland, D. L., Mirnics, Z., & Kirana, P. (2025) · Current Sexual Health Reports · doi:10.1007/s11930-025-00412-w · Cited by 3 · see citing works
“…findings based on this limited sample of HPCs adequately represent the larger population of HPCs treating men with PE, we do believe they offer a preliminary window into the kinds of issues that come into play in their acceptance of clients and prioritizing treatment objectives [e.g., 212 , 213 ].”
An Integrative Approach to the Treatment of Premature Ejaculation
Rowland, D. L., Tuohy, A., & Humpfer, J. (2014) · Current Sexual Health Reports · doi:10.1007/s11930-014-0015-9 · Cited by 3 · see citing works
Rowland, D. L., Kneusel, J. A., Bacys, K. R., Hamilton, B. D., Bhutto, Z. H., & Zadeh, Z. F. (2021) · Journal of Sex & Marital Therapy · doi:10.1080/0092623x.2021.1881671 · Cited by 2 · see citing works
“…(i.e., take responsibility for it) than US women, a process that has the potential to diminish sense of self-efficacy, heighten the expectation for failure, and lead to a self-fulfilling prophecy that sustains or exacerbates the problem (Bandura, 1989; Frank & Maass, 1985; Rowland et al., 2015).”
BackgroundRowland, D. L. (2020) · Springer eBooks · doi:10.1007/978-3-319-59531-3_49-1 · Cited by 2 · see citing works
Makhmudov, A., Tulaboev, A., Rowland, D. L., Aliev, S., & Rikhsiboev, J. (2026) · Sexual Medicine · doi:10.1093/sexmed/qfag039 · Cited by 1 · see citing works
“…as an occasion for shame, embarrassment , and distress rather than an opportunity for pleasure, positive feelings, and intimac y. 9 , 10 , 23 , 24 The psychological burden of PE: Sexual and relationship satisfaction in partners of men with PE Studies have indicated that the man’s PE response…”
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“Self-acceptance in post-operative patients can be increased with knowledge and knowledge will be obtained well when a person has higher education [18].”
BackgroundInfluentialCross Cultural Research: Opportunities and Strategies for Discovery
Rowland, D. L., & Motofei, I. G. (2020) · Trends in andrology and sexual medicine · doi:10.1007/978-3-030-36222-5_19 · Cited by 1 · see citing works
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The Relationship between Erectile Dysfunction, Sexual Self Efficacy and the Dark Triad
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Thevalidation and correlations with empowering leadership and self-efficacy scales
ASLAN, A. P. D. S., & DemetAkarcayUlutas, I. (2015) · JOURNAL OF SOCIAL SCIENCE RESEARCH · doi:10.24297/jssr.v8i3.4089 · Cited by 1 · see citing works
PELVIC FLOOR MUSCLE EXERCISE IMPROVING SEXUAL SELF-EFFICACY
Lolowang, N. L., Afiyanti, Y., & Ungsianik, T. (2019) · Journal of Maternity Care and Reproductive Health · doi:10.36780/jmcrh.v2i1.73
“PFM exercise could improve sexual self-efficacy as a construct that JMCRH: Vol. 2 Issue 1 112 problems in women (Rowland et al., 2015).”
Background
- Authors
- Rowland, D. L., Adamski, B. A., Neal, C. J., Myers, A. L., & Burnett, A. L.
- Affiliations
- Valparaiso University (US)
- Johns Hopkins University (US)
- Corresponding author
- Rowland, David L.
- Venue
- Journal of Sex & Marital Therapy
- Publisher
- Informa UK Limited
- Published
- 2013-12-13
- Volume
- 41
- Issue
- 1
- Pages
- 60-71
- ISSN
- 0092-623X (ISSN-L)
- 1521-0715
- OpenAlex
- W1990697026
- Cited by
- 44
- References
- 26
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 4 · 2021: 6 · 2020: 7 · 2019: 5 · 2018: 1 · 2017: 4 · 2015: 5 · 2014: 1
- FWCI
- 1.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Sex & Marital Therapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Health Sciences › Medicine › Urology › Urological Disorders and Treatments
- Keywords
- sexual self-efficacy, sexual dysfunction, erectile dysfunction, sexual response, male sexual health, sexual motivation, sexual behavior
- MeSH terms
- Adult, Aged, Humans, Erectile Dysfunction, Male, Middle Aged, Psychometrics, Surveys and Questionnaires, Statistics as Topic, Reproducibility of Results, Linear Models, Sexual Dysfunctions, Psychological, Self Efficacy, Health Literacy
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