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ABSTRACT

BDSM, SEX, AND STRESS: THE IMPACT OF STRESS ON SEXUAL ACTIVITY WITHIN
BDSM AND NON-BDSM PRACTITIONERS
Ellen Morgan Lee, M.A.
Department of Psychology
Northern Illinois University, 2014
Brad Sagarin, Co-Director
Larissa Barber, Co-Director
Previous research has demonstrated negative relationships between stress, sexual activity
and related variables; however, much of this work has focused on the response to stressors rather
than the strain response itself. Therefore, this study separated strain into tension (high arousal,
agitation) and depletion (low arousal, exhaustion). Additionally, this study sought to investigate
whether these effects were different for people who engage in BDSM activity and those who do
not. Using a combination of a self-identity and a behavioral measure of BDSM group
membership resulted in 65 Practitioners, 79 Behaviorists, and 83 Non-Practitioners. The results
indicated that, for everyone, depletion was negatively related to not only the frequency of sexual
activity but also how much people psychologically and physically enjoyed the activities.
Tension, on the other hand, was only negatively associated with sexual activity for Practitioners
and with sexual functioning and sexual satisfaction for Practitioners and Behaviorists.

NORTHERN ILLINOIS UNIVERSITY


DEKALB, ILLINOIS

AUGUST 2014

BDSM, SEX, AND STRESS: THE IMPACT OF STRESS ON SEXUAL ACTIVITY WITHIN
BDSM AND NON-BDSM PRACTITIONERS
BY
ELLEN MORGAN LEE
2014 Ellen Morgan Lee

A THESIS SUBMITTED TO THE GRADUATE SCHOOL


IN PARTIAL FULFILLMENT OF THE REQUIREMENTS
FOR THE DEGREE
MASTER OF ARTS

DEPARTMENT OF PSYCHOLOGY

Thesis Co-Directors:
Brad Sagarin and Larissa Barber

UMI Number: 1566634

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ACKNOWLEDGMENTS
I owe gratitude to many individuals, most and foremost my co-chairs, Brad Sagarin and
Larissa Barber. They both provided invaluable expertise and assistance revising the project from
its theoretical beginnings to its final acceptance. I would also like to thank Betty La France for
being such an interested reader, who makes me hope that other people find these topics as
exciting as I do. And finally, this thesis would not have been possible without the help of
hundreds of individuals who spent the time answering lots of questions and sharing a bit of
themselves.

DEDICATION
To my parents, Bill and Cheryl Lee
Thank you, for everything.

TABLE OF CONTENTS
Page
LIST OF TABLES... vii
LIST OF FIGURES.....

viii

LIST OF APPENDICES......

ix

Chapter
1. INTRODUCTION.......

BDSM as Pathology ...... 2


BDSM as Normative Behavior .................................................................................. 5
BDSM and Stress Relief .... 13
Stress and Sexual Activity ..... 17
The Stress Process and Definitional Issues: Stressors, Strain, and Coping ... 19
Main Hypotheses ............ 25
Explanatory Variables .... 31
Exploratory Variables ..... 32
2. METHOD ..... 34
Participants and Procedure .... 34
Materials........ 38
Demographics ....... 38
Tension ............. 39

v
Chapter

Page
Depletion............... 39
Coping .............. 40
Physical, Sexual, and BDSM Activity ...... 41
Sexual Dysfunction .......... 42
Sexual Motivation ................ 43
Relationship Satisfaction ................. 44
Self/Other Overlap ............... 44

3. RESULTS ... 45
Preliminary Computations and Analyses ..... 45
BDSM Status as a Moderator of the Relationship
between Strain and Sexual Activity.

46

BDSM Status as a Moderator of the Relationship


between Strain and Sexual Desire ...

50

BDSM Status as a Moderator of the Relationship


between Strain and Sexual Functioning...

51

BDSM as a Moderator of the Relationship


between Strain and Sexual Satisfaction.. 53
Differences in Sexual Activity Frequency among BDSM Groups .... 56
Differences in Tension and Depletion among BDSM Groups ... 58
BDSM Group Differences in Coping .... 59
BDSM Role as a Moderator of the Strain and Sexual Activity Relationship .... 60
Additional Exploratory Mean Differences between BDSM Roles .... 65
BDSM Groups and Differences in Sexual Motivation ... 66

vi
Chapter

Page

Relationship Satisfaction/Self-Other Overlap as Moderators of the Relationship


between Strain and Sexual Activity ....... 68
4. DISCUSSION....... 71
Conceptualizing Stress as Strain ........ 71
Investigating BDSM Practitioners ........ 72
Strain and Sexual Activity ..... 74
Strain and Sexual Desire, Sexual Functioning, and Sexual Satisfaction .... 77
Avoidance Coping .. 80
Differences between Tops, Bottoms, and Switches ...... 80
Limitations and Future Research Directions .... 83
Conclusion .... 86
REFERENCES..... 87
APPENDICES...... 91

LIST OF TABLES
Table

Page

1. Demographic Variables by Group ............. 37


2. Correlations and Means/Standard Deviations among
Tension, Depletion, and Dependent Measures .......... 46
3. Independent and Dependent Measures by Group .......... 57

LIST OF FIGURES
Figure

Page

1. Effect of Tension on Total Sexual Activity by Group . 48


2. Effect of Depletion on Total Sexual Activity by Group .. 49
3. Effect of Tension on Sexual Functioning by Group 52
4. Effect of Depletion on Sexual Functioning by Group . 53
5. Effect of Tension on Total Sexual Satisfaction by Group ... 54
6. Effect of Depletion on Total Sexual Satisfaction by Group 55
7. Effect of Tension on Total Sexual Activity by BDSM Role ... 61
8. Effect of Depletion on Total Sexual Activity by BDSM Role ..... 62

LIST OF APPENDICES

Appendix

Page

A. DEMOGRAPHICS AND RELATIONSHIP CHARACTERISTICS (FIRST


PART)........... 92
B. STRESS SUBSCALE OF THE DASS STRESS SCALE (ANTONY, BIELING, COX,
ENNS, & SWINSON, 1998; LOVIBOND & LOVIBOND, 1993, 1995) ....... 97
C. SHIROM-MELAMED BURNOUT MEASURE (SHIROM & MELAMED, 2006) .. 99
D. AVOIDANCE SUBSCALE OF THE COPING STRATEGY INDICATOR
(AMIRKHAN, 1990; DESMOND, SHEVLIN, & MACLACHLAN, 2006) .. 101
E. PHYSICAL, SEXUAL ACTIVITY AND BDSM ACTIVITY.......... 103
F. ARIZONA SEXUAL EXPERIENCES SCALE (MCGAHUEY, GELENBERG,
LAUKES, MORENO, DELGADO, MCKNIGHT, & MANBER, 2000) . 109
G. AMORE (AFFECTIVE AND MOTIVATIONAL ORIENTATION RELATED
TO EROTIC AROUSAL QUESTIONNAIRE) (HILL & PRESTON, 1996) ... 111
H. THE RELATIONSHIP ASSESSMENT SCALE (HENDRICK, 1988) .... 114
I. INCLUSION OF OTHER IN SELF SCALE (ARON, ARON, & SMOLLAN, 1992).. 116
J. DEMOGRAPHICS AND RELATIONSHIP CHARACTERISTICS (SECOND PART)... 118
K. RECRUITMENT INFORMATION (POSTED ON MTURK AND FETLIFE)..... 120
L. INFORMED CONSENT INFORMATION ... 122
M. DEBRIEFING INFORMATION .... 124

CHAPTER 1
INTRODUCTION

Sexual activity within romantic relationships is a healthy part of dyadic functioning. It


helps to deepen and reinforce the emotional and physical bonds between couples (Davis, Shaver,
& Vernon, 2004; Hendrick & Hendrick, 2002), and it can also act as a stress reliever (Ein-Dor &
Hirschberger, 2012; McCarthy, 2003). A significant amount of research has studied sexual
activity within the general population (Bodenmann, Ledermann, & Bradbury, 2007; Morokoff &
Gillilland, 1993), but certain sub-populations remain understudied (Newmahr, 2010). One of
these populations is the bondage/discipline (B&D)-dominance/submission (D&S)
sadism/masochism (S&M; BDSM) community. The current research is primarily aimed at better
understanding the sexual and physical activity within this particular community. The critical
component under investigation is the role of stress. In particular, this study will explore whether
increases in stress lead to increased or decreased BDSM and sexual activity. This research will
expand the literature and broaden the understanding of the reasons BDSM individuals engage in
particular types of sexual and physical activities.
First, this paper will discuss the literature on BDSM as a pathology. Some researchers
have viewed BDSM as unhealthy behavior done by mentally unstable individuals, so evidence
for this will be explored. Second, a discussion on BDSM from a more normative perspective will
follow. Some researchers have hypothesized that people are motivated to engage in BDSM

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behavior in order to reduce stress; therefore stress and its effects on sexual activity will be
discussed. Finally, the study hypotheses, including potential moderators, will conclude the
introduction.
BDSM as Pathology
In 1885, medico-forensics expert Krafft-Ebing wrote a book entitled Psychopathia
Sexualis which popularized the terms sadism and masochism (Brame, Brame, & Jacobs,
1993; Weinberg & Kamel, 1983). Krafft-Ebing described sadism as the innate desire to humiliate
or wound others (and/or animals) and the resulting sexual pleasure one receives through harming
others. He referred to masochism as the sexually arousing desire to be completely controlled,
humiliated, and abused by another person. Krafft-Ebing also discussed how masochists primarily
live in fantasies and often attempt to create situations where these fantasies will be realized.
According to Krafft-Ebing, any sexual behavior not intended for reproduction was perverse and
deviant (including masturbation), but sadism and masochism were among the most terrible (as
cited in Brame, Brame, & Jacobs, 1993). Even though sadism and masochism were regarded as
highly perverse by Krafft-Ebing, he claimed that deviant behavior could be traced back to more
typical sexual horseplay acts, including biting, pinching, and wrestling (as cited in Weinberg &
Kamel, 1983). Krafft-Ebings Psychopathia Sexualis is considered one of the most influential
writings on sadomasochism and one of the primary reasons the terms became imbued with such
negative connotation. It was about this time (the 19th century) when society and clinicians began
to see sadomasochistic behavior as pathological sexual perversion (Hanly, 1995).
Psychoanalysts have long explored the content of sadomasochism and where these types
of desires come from. Sigmund Freud, for example, explained that sadism and masochism were

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two parts of the same entity. He believed that a sadist experienced pleasure (oftentimes sexual)
from causing pain to others but that a sadist could also experience pleasure from receiving pain.
He referred to sadism as the active side of the perversion and masochism as the passive side, and
whichever one was more strongly developed (Freud, 1938, p. 570, as cited in Weinberg &
Kamel, 1983, p. 19) became the primary mode of sexual activity. According to Freud, ones
circumstances in childhood result in one side expressing itself more strongly than the other.
Most of his writing takes the perspective that sadomasochism is primarily driven by a childs
complex love/hate relationship with his or her parents and the childs dependence upon them (as
cited in Hanly, 1995). Freuds definition clearly roots sadomasochism in pathology, where the
desire to receive and inflict pain is a perverse neurosis.
Another psychoanalyst, Hanly, writes:
Masochism is a psychoanalytic concept which has served as a vehicle to open up
pathways of understanding into human lives where rituals of pain and sexual abusiveness
prevail, and into unconscious fantasies constructed out of psychological pain, desperate
need, and sexually excited, self-destruction. (1995, p. 1)
This quote further demonstrates the pathology typically attributed to masochistic desires and how
psychoanalysts clearly characterize SM as unhealthy and harmful behavior.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, 2000) defines
sexual sadism as over a period of 6 months, recurrent, intense sexually arousing fantasies,
sexual urges, or behaviors involving acts (real, not simulated) in which the psychological or
physical suffering (including humiliation) of the victim is sexually exciting to the person. The
person has acted on these urges with a non-consenting person, or the sexual urges or fantasies
cause marked distress or interpersonal difficulty. The DSM currently designates sexual sadism
and sexual masochism as paraphilias, and thus treats them both as pathology. Other psychiatric

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literature links sadomasochism with activities such as rape and murder (Ehm & Patrick, 1995;
Gratzer & Bradford, 1995, both as cited in Cross & Matheson, 2006).
Some researchers claim, however, that there is little evidence to suggest that BDSM
practitioners meet the criteria for the definition of a mental disorder (Moser & Kleinplatz, 2006;
Williams, 2006). There have been many studies investigating the demographics and personality
characteristics of the BDSM population. For example, Connolly (2006) gave a Californian
sample of BDSM practitioners a battery of inventories to study if BDSM practitioners would
evidence signs of clinical disorders that psychoanalysts would typically attribute to this
population, such as depression or borderline pathology. Connolly found that BDSM
practitioners, compared to previously published norms, scored lower on depression, anxiety,
post-traumatic stress disorder, psychological sadism, psychological masochism, borderline
pathology, and paranoia. BDSM practitioners did, however, exhibit higher than average scores
on the narcissism and disassociation measures. The results from Connollys (2006) work suggest
that BDSM individuals do not suffer from mental or personality disorders, as perhaps would be
expected by popular belief-- either by psychoanalysts or the general public. Furthermore, and
again perhaps contrary to expectations, research has found that BDSM practitioners typically
have higher levels of income and education compared to non-BDSM practitioners (Sandnabba,
Santtila, & Nordling, 1999; Weinberg, 1987). Given this evidence that BDSM does not arise
universally from pathology, we turn to the work of researchers adopting a more normative
perspective.

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BDSM as Normative Behavior
The BDSM community has offered their own definitions with the intent to clarify how
BDSM is used and to separate it from pathology. Brame, Brame, and Jacobs (1993) conducted
over 100 interviews with BDSM community members with the intention of providing the public
with a more positive, normative depiction of BDSM behavior. They explain that the term
sadomasochism has become loaded with incredibly negative connotations, and thus, some
BDSM practitioners choose to use less controversial terms like dominance and submission
(DS) or bondage and discipline (BD) to refer to their activities. The authors claim that the
word sadist does not differentiate between a criminal sadist who enjoys causing desperate
agony in a victim and the sexual sadist who seeks romantic fulfillment with an eager and
consenting partner (Brame et al., 1993, p. 47). The words and actual terminology used to
describe BDSM behavior have clearly become emotionally charged over the years. It is not
surprising then that BDSM community members have sought to redefine their behaviors as more
normative and positive.
Wiseman (1996) defines SM as the knowing use of psychological dominance and
submission, and/or physical bondage, and/or pain, and/or related practices in a safe, legal,
consensual manner in order for the participants to experience erotic arousal and/or personal
growth (p. 10). Although Wiseman uses the terminology SM throughout his book, he states
that BDSM can be used as an overall descriptive term (p.11) that includes bondage, dominance
and submission (DS) and sadomasochism (SM). He goes on to say that SM can be described
very broadly, including activities such as biting or scratching, spanking, holding the other person
down, or giving any sort of order. Wisemans definition explains that BDSM incorporates a

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variety of activities (in a wide spectrum of intensity) that can be combined in a multitude of
different ways and used for different purposes.
Some BDSM researchers have claimed that there are five common features to these types
of activities: the appearance of dominance and submission, role playing, mutual definition,
consensuality and a sexual context (Moser & Kleinplatz, 2006; Weinberg, Williams, & Moser,
1984). By mutual definition they mean that both parties define their activities together, in that
they may not call their activities SM, but these individuals recognize their behaviors are
somehow different than normal sex. Moser and Kleinplatzs (2006) definition of SM makes a
sexual context essential, but they do acknowledge that some people may not define their
activities as sexual.
Scott (1997) breaks down BD, DS, and SM separately, in that each incorporates different
activities. She refers to BD as the erotic use of assorted restraints and commands (p. ix), DS as
consensual power exchange (including use of costumes, fetishes, cross-dressing, and
infantilism), and SM as exchanges involving eroticized mental, emotional, or physical pain (p.
ix).
It could be argued that the activities described by the clinical and community definitions
are somewhat similar in nature: bondage, pain, dominance, etc. The biggest difference between
the pathological and normative definitions of BDSM is the intent behind or reason for the
behavior. Through these various definitions we can see that erotic arousal and sexual enjoyment
may be the intent of some individuals engaging in BDSM activities, but for others it may not be.
To go even further, sometimes people may be engaging in behavior typically defined as BDSM
without even knowing it. For example, does a woman dressing up in a French maid outfit for her

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husband identify with the BDSM community? To this end, Brame, Brame, and Jacobs (1993)
make the following claim: The two important distinctions between those who playfully
incorporate aspects of D&S into sexual intimacy and those who define themselves as D&Sers are
consciousness and degree of erotic need (p. 7). Therefore, in this study a very general
description of activities (typically thought of as BDSM behavior) were provided for participants
so that they could classify themselves as people who engage in those particular activities or not.
This classification helped differentiate between the two groups of interest in this study: people
who engage in BDSM behavior and those who do not.
Another component of BDSM that needs definition is the different roles that people take
on during the activities. Similar to the definition of BDSM, there exists some variation between
the characterizations of the roles. Wiseman (1996) describes a dominant as someone who gives
orders during BDSM activity, whereas a submissive is a person who obeys orders during BDSM
activity. As previously discussed, a sadist is someone who likes giving pain, and a masochist is
someone who likes receiving pain. In a more general sense, a top is someone who is the
dominant or the sadist, and a bottom is someone who is the submissive or a masochist. A top
may refer either to someone who either likes being in control or someone who likes
administering sensations to another. Similarly, a bottom may refer either to someone who likes
being controlled or someone who likes receiving various sensations. A switch is typically used to
refer to someone who will take on either a top or a bottom role depending on the partner(s) or the
situation. It is important to note that not all bottoms are masochists, nor are all tops sadists, and
different combinations can exist; for example, a top can also be a masochist. Individuals in this
study who identified as someone who engages in BDSM activities were also asked to define the

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role(s) they take on. In order for people to define their role(s), participants were asked questions
about their preferences for receiving and/or giving sensations, being in control, etc. By allowing
people to classify themselves, this study investigated how stress may impact BDSM individuals
in different ways depending on their particular interests.
Although the definition of BDSM may vary, one theme is prevalent across BDSM
community definitions: consent. Wiseman (1996) states that consent is one of the most
important issues, perhaps the most important issue, in SM (p. 47). Furthermore, Wiseman
clearly differentiates abuse from SM behavior in his book. According to Wiseman, SM behavior
differs from abuse because it includes consent, minimal risks to anothers physical and emotional
well-being, the ability for the submissive to stop activities at any time, negotiation, and gratitude,
whereas abuse includes none of these. Brame, Brame, and Jacobs (1993) explain, The practices
and attitudes of contemporary sexual dominants and submissives largely abide by the credo of
Safe, Sane, and Consensual. Partners emphasize equal and honest communication, negation,
and consent; mutual trust is fundamental. A partners limits and preferences are respected (p. 5).
Consent means that individuals knowingly accept and desire whatever activities or
behaviors they are engaging in. Consent also implies that individuals are mentally capable of
both seeking and giving their approval for the activities. For the purposes of this study, for any
individual identifying as a BDSM community member or for anyone interested in BDSM
behavior, we assumed that all participants engage in consensual BDSM. As an interesting side
note related to the earlier discussion on the types of roles people take on within BDSM
interactions, lay culture beliefs typically hold that a top holds all the power over a bottom, but as
Weinberg and Kamel (1983) point out, situations involving SM typically involve acting out, and

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thus fulfilling, a masochists fantasies. Masochists and sadists work together to put restrictions
on these scenarios and sadists who are known to exceed limits often find themselves without
partners. Thus, Weinberg and Kamel posit that it is the masochist who is truly in charge. As this
study is investigating the impact of stress on sexual behavior within intimate relationships,
including non-BDSM relationships, we also assumed that any sexual activity between partners is
also consensual.
Wiseman (1996) suggests that many people may have negative feelings towards BDSM
because they conjure up images of rape, wife-beating, mental coercion, kidnapping, and
psychopathic torture (pp. 16-17). The media often portray BDSM behavior as violent and
nonconsensual, which only serves to reinforce the negative stereotypes of those who engage in
BDSM behavior. Wiseman goes on to say, I think many people feel repelled by SM because
they mistakenly see it as cruelty. SM is not cruelty (p. 17). As previously discussed, this may
be one of the many reasons why people have sought to redefine BDSM or to find more nuanced
terminology. So if BDSM is not cruelty, nor is it fulfilling some dark pathological need on behalf
of the practitioners, what is BDSM doing for people? Why do people engage in BDSM
behavior?
As a self-proclaimed BDSM community member, Wiseman (1996) sees BDSM behavior
as an erotic interaction between risk-aware, conscientious, mentally stable individuals and
therefore depicts BDSM behavior as non-pathological. Wiseman clearly articulates that BDSM
can be used not only for sexual purposes but also as a tool for personal development. He notes
that people frequency use the word play to refer to the act of engaging in BDSM activities.
After two years studying BDSM community members, Scott (1997) explains the purpose behind

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the behavior in a similar way: I did not find them to be psychologically troubled or socially
inept; rather, a spirit of good humor and fun prevailed (p. x). The use of the word play
suggests that BDSM behavior is positive and fun; it could be considered a leisure activity
(Williams, 2006).
Consistent with Wisemans reasoning behind BDSM, Scott (1997) declares that the
primary reason most people get involved in DS activity is that it offers greater eroticism than
what the BDSM community refers to as vanilla sex. Vanilla or vanilla sex typically refers
to conventional sex or sexuality that is non-BDSM (Williams, 2006). Through this increased
eroticism people experience greater sexual satisfaction and excitement. Scott claims that D&S
fulfills psychological needs, such as losing control or experiencing power, and through these
needs being fulfilled, people experience intense emotions. She says, sexual intensity is
heightened as participants enact deeply held fantasies, experiment with role reversal, exercise
and exchange power, and explore and challenge their abilities to experience pain, pleasure, and
other sensations (p. 4). Scott explains that people use D&S activities as a creative sexual
expression which ultimately leads to increased personal enjoyment.
Not only does increased eroticism affect ones sexual and emotional satisfaction, but it
also seems to positively impact the connection one feels to another person. Scott (1997) goes on
to say, . many D&Sers find through the sexual interchange a profound closeness, intimacy,
and sense of communication and trust with one partner, particularly when they are involved in a
long-term D&S relationship, coupled with a greater awareness of self, and an experience of selfexpansion, as they explore new realms of creative sexual expression (p. 3). This is also echoed
by Brame, Brame, and Jacobs (1993): For active D&Sers sadomasochism is a thoughtful and

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controlled expression of adult sexuality that holds the promise of intense intimacy and sharing
(p. 5). Scott also describes how this increased closeness with others can lead people to receive
spiritual enrichment and fulfillment. Similarly, prominent BDSM researchers and authors Moser
and Kleinplatz (2006) explain that spirituality may be a nonsexual purpose behind BDSM
behavior for some individuals. Another piece of evidence that suggests that BDSM behavior can
sometimes be non-sexual is that people will engage in BDSM activities with people they are not
sexually attracted to or have no desire to be sexual with (Newmahr, 2010). Therefore, feeling
sexually turned on by someone might not be a prerequisite for people to feel more emotionally
connected to others after engaging in BDSM activities.
Through the community writings we can see that some view BDSM as a fun, playful
(albeit sometimes very intense) range of activities that can be used to create and cement intimacy
between two (or more) people. This intimacy and communication between individuals is seen as
positive and enriching for each person involved. Others experience personal fulfillment or
spiritual enhancement from engaging in BDSM behavior. Additionally, sometimes people
receive sexual pleasure or arousal from these behaviors, which can be very enjoyable, but this is
not always the case.
Other researchers have cited the desire for an altered state of consciousness as one of the
motivations behind SM behavior (Weinberg, Williams, & Moser, 1984). One prevalent theory
for masochism is that pain changes ones mental perspective and more often times than not, this
change is considered pleasant and personally enriching. Karl Marx (1966) said that there is
only one antidote to mental suffering, and that is physical pain (as quoted in Scarry, 1985, p.
33). A quote from a BDSM community member echoes a similar sentiment in a slightly different

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way: I need to feel really heavy pain about every six weeks or so, or I get really bitchy
(Wiseman, 1996, p. 19). In her discussion on torture, Scarry (1985) describes how pain destroys
a persons self and world (p. 35) where ones mental perspective is radically shifted. She
explains that this shift can often result in feeling more connected with the universe where the
sense of self disintegrates. Although Scarry is primarily referring to non-consensual torture, it is
possible that engaging in consensual activities that cause such intense physical pain could result
in similar psychological effects.
The discussion on pain may offer some explanation for a masochists desire to engage in
BDSM, but not every individual in the community enjoys pain. For some people the idea of pain,
rather than pain itself, is arousing (Moser & Kleinplatz, 2007). To this point, Weinberg and
Kamel (1983) state that the majority of BDSM behavior does not involve physical pain (e.g.,
cross-dressing, humiliation, or simply being tied up). They posit that the concept of helplessness,
and subsequent possibility of violence, is sufficiently (sexually) titillating for many people.
Therefore, it is not necessarily the pain that is arousing, but the idea of control which manifests
itself through dominance and submission.
The previous section demonstrates that people might be motivated to engage in BDSM
behavior not only for pain but also for the psychological excitement of power exchange in which
the threat of pain is present. Furthermore, the pain people experience, or even the illusion of
pain, may or may not be considered erotic. This echoes the community perspectives that BDSM
serves a multitude of purposes. These purposes may be endorsed differentially depending on the
role (top, bottom, etc.) individuals maintain. It is hoped that this study will help elucidate why
top and bottoms alike engage in BDSM and sexual activity.

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BDSM and Stress Relief
As discussed before, BDSM is often referred to as play by BDSM practitioners
(Wiseman, 1996) and others claim that it can reduce stress (Williams, 2006). Newmahr (2010)
suggested that BDSM is a serious leisure activity designed to help relieve stress. Borrowing from
serious leisure activity researcher Stebbinss work (1982, as cited in Newmahr, 2010), Newmahr
claimed that BDSM activity holds very similar qualities as other types of serious leisure, like
mountain climbing or kayaking. Whereas casual leisure is immediately gratifying, typically
short-lived, and does not require any special skills, serious leisure requires long-term
involvement and special training. Serious leisure has six qualities that separate it from casual
leisure (as paraphrased in Newmahr, 2010): a) need for perseverance, b) leisure pursuit as a
career, c) effort in the acquisition of skills, d) personal and social-psychological benefits, e) spirit
of community, and f) personal identification with the leisure activity. Therefore, Newmahr posits
that people within the BDSM community see their activities as serious leisure; BDSM
practitioners are motivated to engage in these behaviors to demonstrate their skills, connect with
others, and reap positive psychological benefits.
Baumeister (1988) proposed the escape from self theory to help explain why people
engage in masochistic behavior. The concept of the self has been theorized to facilitate the
pursuit of many goals, such as the individuals desire to be happy, avoid suffering and loss, and
maintain a positive image both internally and externally (Baumeister, 1988). People are also
driven to increase their self-esteem, the overall sense of worthiness and value. In order to
accomplish these goals, the self needs to exert control over the environment, and this effort can
often become burdensome and overbearing. If people need to exert control over their

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environment to meet high expectations and fulfill responsibilities, then masochism, which is
defined by relinquishing control, represents a paradox for the self. However, Baumeister explains
that people are often driven to escape this overbearing sense of self. He claims that masochistic
activities can be a way for people to escape the higher, more abstract, stressful levels of selfawareness (such as meeting high expectations, fulfilling responsibilities, or raising self-esteem).
Masochistic activities, like bondage, humiliation, and pain, focus an individual on lower, less
stressful levels of self-awareness; individuals are more focused on the immediate present and the
physical sensations (and emotional experiences) they are currently having. This idea is also
reflected in Scarrys (1985) description of what happens to a persons experience of oneself
while in pain.
Baumeister (1988) claims that masochism, ironically, is both a way to regain control and
a way to improve self-esteem by escaping to a lower level of self-awareness; this is particularly
appealing for those who are significantly burdened by autonomous selfhood. Baumeister
suggests that the more responsibility and esteem the individual accumulates, the more difficult
and exhausting it is to sustain them (p. 36). The more people feel the weight of selfhood, the
more likely they would be to wish to temporarily escape their sense of self, and by actively
deciding to relinquish control, people can purposefully avoid and/or forget aversive emotions.
Thus, the insistent needs of the self are momentarily lightened. Baumeister groups BDSM with
other escape tendencies like skydiving and getting drunk, suggesting that the reasons why
someone would choose one activity over another depends on accidents of habit, opportunity,
and association (p. 54). Baumeister notes that one such association may be the link with sexual
desire, and if sexual desire and BDSM behavior occur together repeatedly enough, people will

15
begin to seek out BDSM behavior as a means for sexual pleasure, or they may use BDSM to
enhance sexual pleasure.
Cross and Matheson (2006) conducted a series of studies to test different theories for why
people in engage in BDSM behavior. In their first study they sought evidence to support the
escape from self theory. Specifically, they wanted to determine if masochists had a greater
tendency to engage in escapist behaviors than non-BDSM-practicing individuals or other
BDSM-practicing individuals, such as sadists. In their study they asked BSDM practitioners and
non-BDSM practitioners to take a variety of personality scales to test the escape from self
theory: danger seeking, role-playing proclivity, day-dreaming proclivity, use of recreational
drugs, desire for control, locus of control, and submissive proclivities. No significant differences
were found between the different population groups; therefore, they claimed they found no
support for the escape from self theory.
In the Cross and Matheson (2006) study, participants were also asked about the amount
of sexual behaviors they engaged in, and it was found that BDSM practitioners reported as
being more sexually active, with a wider range of sexual activities in their repertoire, and a
broader range of partners (p. 148). The authors go on to say that these findings suggest that
sadomasochism may simply be a form of sex play, providing those individuals with a sufficiently
adventurous attitude towards sex with the experience of intense and intimate encounters (p.
148).1

Cross and Matheson (2006) also did not find support for psychoanalytic theories (masochists did not evidence
greater sexual guilt than non-masochists; sadists were not driven by impulsivity), psychopathological theories
(masochists did not evidence greater psychological distress or mental instability that non-masochists), or radical
feminist hypotheses (SM practitioners did not endorse anti-feminist beliefs or more traditional gender roles than the
normal population).

16
Cross and Matheson (2006) took an individual difference perspective toward the escape
from self theory in which they sought evidence that masochism is a result of a particular
personality variable, but a different reading of the theory might be that masochism is one method
in a myriad of methods used to escape burdensome selfhood (e.g., skydiving, getting drunk). It
may be that masochists do not have a greater need to escape the self than non-masochists, but
they just choose a particular method that serves the same function as other methods to reduce
stress. Consistent with this, Baumeister (1988) explains that, if the present theory is correct,
masochistic desires should increase after severe external demands for autonomy, responsibility,
decisions, self-assertion, and esteem maintenance (p. 54.).
Therefore, this study examined whether individuals experiencing a period of burdensome
selfhood will exhibit more BDSM behavior. Consequently, we are using stress as a proxy for
more burdensome selfhood. If the escape from self theory is interpreted to mean that people are
driven to engage in BDSM behavior because of increases in stress, then masochistic activities
should increase as stress increases, at least among those who enjoy pain. If BDSM can either be
thought of as sex play or as a serious leisure activity, however, it might mean that this kind of
behavior will be desired after periods of greater stress not only by masochists but by anyone with
a particular interest in these kinds of activities. The current research will examine whether the
relationship between stress and BDSM activity is only prevalent for masochists and not other
types of BSDM individuals, such as tops or switches. Furthermore, as suggested by the
definitions of BDSM behavior, if BDSM activity is often coupled with sexual activity, then
sexual activity might also increase. Therefore, this study sought to find empirical support for the
escape from self theory and whether or not a burdensome self (via stress) leads to more BDSM

17
activities and/or sexual activities. In order to make predictions about this relationship, the
literature on stress and sexual activity will be explored next.
Stress and Sexual Activity
Much research has been devoted to studying the relationship between stress and physical
intimacy. Some evidence suggests that couples experiencing greater amounts of sex, both in
quality and frequency, have greater feelings of love (Hendrick & Hendrick, 2002) and lower
levels of marital conflict (Metz & Epstein, 2002). Other work has shown that dyadic stress
(conceptualized as marital conflict and tension) covaries with lower sexual satisfaction and
greater sexual dysfunction (Hurlbert, Apt, Hurlbert, & Pierce, 2000). Some researchers have
even hypothesized that sexual activity can act as a stress reliever (Ein-Dor & Hirschberger, 2012;
Morokoff & Gillilliand, 1993).
Bodenmann, Ledermann, and Bradbury (2007) collected cross-sectional survey data from
198 Swiss couples to test mediation relationships between stress, marital satisfaction, sexual
activity, sexual satisfaction, and sexual dysfunction. They were particularly interested in
determining the dyadic and reciprocal effects of external stress (e.g., daily hassles) and internal
stress (e.g., relationship arguments) on couples sexual activity. The results indicated that
couples experiencing higher levels of external daily stress also experience higher levels of stress
and tension within the dyad and, in turn, lower levels of relationship and sexual satisfaction,
sexual activity, and (to a moderate extent) more sexual dysfunctions (p. 561). Evidence was
found that higher levels of daily hassles (stress) were associated with greater amounts of sexual
activity, but it was mediated by relationship satisfaction. Furthermore, this pattern between daily
hassles and sexual activity was different for men and women. Among maritally satisfied women,

18
sexual activity did not covary with stress, but among medium, and low- satisfied women, sexual
activity decreased with increased stress. Similar to maritally satisfied women, sexual activity of
satisfied men did not covary with stress, but with low, and medium- satisfied men, increases in
stress were associated with increased sexual activity. It appears from this work that relationship
satisfaction can be an important variable in understanding the relationship between stress and
sexual activity.
Another cross-sectional study by Bodenmann and colleagues looked at the relationship
between stress and sexual problems within 198 couples (Bodenmann, Ledermann, BlattnerBollinger, & Galluzzo, 2006). The authors conclude that internal daily stress was most related to
sexual problems, including hypoactive sexual desire in both women and men, vaginismus
(automatic tightening of the pelvic floor muscle) in women, and premature ejaculation in men.
The results from these two cross- sectional studies clearly indicate that stress plays a critical role
in marital functioning, particularly sexual activity.
Bodenmann, Atkins, Schr, and Poffet (2010) used a longitudinal design to study the
association between stress and sexual activity. Their sample consisted of 103 women who
completed questionnaires and diary entries over a period of three months. Participants were
asked questions about their relationship satisfaction, sexual activity and sexual satisfaction,
experience with orgasm, stress level and their coping strategies (both individual and dyadic).
Bodenmann et al. claimed that the data supported a substantial and significant association
between subjective stress and lower sexual activities (p. 277). The results also indicated that
although there was a negative association between stress and sexual activity, sexual satisfaction

19
(or ability to orgasm) was not affected. It appeared that once sexual activity began, regardless of
stress level, women received sexual pleasure and were satisfied with the activities.
The aforementioned study also explored individual and dyadic coping as moderators of
the association between stress and sexual activity. Results indicated that dyadic coping was
positively associated with sexual behavior, but there was no evidence of moderation. Individual
coping was not associated with sexual behavior. Individual and dyadic coping was, however,
positively associated with sexual satisfaction, but only dyadic coping significantly predicted
orgasm. The results from this study make clear that coping is an important variable to study
while investigating the relationship between stress and sexual activity.
The Stress Process and Definitional Issues: Stressors, Strain, and Coping
The aforementioned findings with respect to stress and sexual activity raise a few
questions. Why do people engage in less sex when they experience increases in stress? What is it
about stress that possibly causes people to lose interest in sex or possibly have a difficult time in
becoming sexually aroused? In order to answer these questions, a review of the stress literature is
needed.
Although stress is a commonly used term, the actual definition and theoretical
components of stress are varied. Walter Cannon is cited as the first modern scientific researcher
to use the word stress in relation to individuals (as cited in Hobfoll, 1989). Cannon described
stress as the bodys reaction to extreme conditions, such as low blood sugar, exposure to cold,
and lack of oxygen. Even though Cannon used the term stress fairly loosely, he was among the
first to discuss how stress could be measured empirically.

20
In the 1950s, Hans Seyle continued to conceptualize stress as a response and used the
term in a very special, technical sense to mean an orchestrated set of bodily defenses against
any form of noxious stimulus (including physiological threats), a reaction that he called the
General Adaptation Syndrome (Lazarus & Folkman, 1984, p. 2). However, one criticism of the
conceptualization of stress as a general response is that it does not take into account individual
differences or the context in which in the stress occurs. An illustration of this criticism comes
from research testing the Yerkes-Dodson law (1908). The Yerkes-Dodson law posits that
increments in arousal improve task performance to a point, but at a certain level performance
begins to be impaired. Various experiments have demonstrated that under different conditions of
stress, responses are not uniformly impaired or facilitated (Lazarus & Folkman, 1984).
In contrast to stress as a general response, another way that people have conceptualized
stress is viewing it as an actual stimulus. Within this theoretical framework, the terminology
stressors is used to refer to the cause of stress, while strain refers to the stress response or
outcomes of stressors. Elliot and Eisdorfer (1982) proposed four types of stressors (as cited in
Hobfall, 1989): a) acute, time-limited stressors (e.g., dentist visit), b) stressor sequences (e.g.,
divorce), c) chronic, intermittent stressors (e.g., student exams), and d) chronic stressors (e.g.,
debilitating illness). Events in this case are considered stressful on the basis of whether they
normally lead to stress reactions. That is, if the stimulus usually leads to emotional upset,
psychological distress, or physical impairment or deterioration, then the stimulus is said to be a
stressor (Hobfall, 1989, p. 514). One main criticism of the stressor conceptualization is that
everyone does not experience stressors in the same way. What might be very stressful for one
individual (e.g., an exam), might not be considered as stressful for another individual.

21
The family stress model (Greenberg, 1987) proposes that there are three components to a
persons experience of stress: family stressors, extra-family stressors, and their individual
characteristics. Family stressors include role overload, role ambiguity, role conflict, sexual
dissatisfaction, and relationship dissatisfaction. Extra-family stressors can include work,
extended family, friends, and life crises. The impact of these stressors depends on ones
individual characteristics, such as self-esteem, anxiety, neuroticism, social skills, and physical
health. Evidence suggests that throughout a persons lifespan negative effects of stress are
buffered by social relationships on both psychological and biological levels (Taylor, 2011). For
example, research has shown that having a satisfying marriage may serve a protective function
during times of stress, particularly for women (Revenson & DeLongis, 2011, p. 101). There is,
however, other evidence to suggest that stress is a threat to the satisfaction and longevity of
marriage (Randall & Bodenmann, 2009). Studies investigating the correlation between major life
stressors and relationship quality have been inconsistent, especially when considering whether
the event was internally or externally caused (Randall & Bodenmann, 2009). Sometimes these
stressors can cause greater cohesion, but it also has the potential to cause separation and
isolation. Results are more consistent with minor life stressors and relationship quality, in that
daily stressors are more associated with relationship deterioration over time. (Randall &
Bodenmann, 2009). These results demonstrate the need to move away from studying stress using
stressors and instead investigate how people experience stress.
Lazarus claimed that stress, then, is not a variable but a rubric consisting of many
variables and processes (Lazarus & Folkman, 1984, p. 13). Consequently, Lazarus and Folkman
(1984) presented their transactional model of stress: Psychological stress is a particular

22
relationship between the person and the environment that is appraised by the person as taxing or
exceeding his or her resources and endangering his or her well-being (p. 19). This definition
implies that it is not necessarily important what is causing stress, but rather the reaction that
people are having in response to the stimuli (also better known as strain). According to
Lazarus and Folkman (1984), in order for a person to experience strain they must first perceive
the situation as stressful (the primary appraisal) and then it must be perceived as threatening (the
secondary appraisal). Primary appraisals can be perceived as a) irrelevant, b) benign-positive, or
c) stressful. Stressful appraisals mean that harm/loss, threat, and challenge will be perceived.
When one of these perceptions is made, then people are called to manage the situation.
Secondary appraisals is a complex evaluative process that takes into account which coping
options are available, the likelihood that a given coping option will accomplish what it is suppose
to, and the likelihood that one can apply a particular strategy or set of strategies effectively (p.
35). The transactional model of stress demonstrates that in order to understand the impact of
stressors on a persons general stress response, an individuals perception of those stressors must
be taken into consideration.
What these stress models make clear is that individuals perceive stressors differently, and
not all stressors necessarily lead to strain across individuals and situations. Therefore, this study
did not investigate stress from a stressor standpoint but rather assessed the actual type of strain
that participants feel. Strain might be experienced in two different ways: tension and depletion.
One way that researchers have sought to define strain is to separate it from other psychological
or emotional states. Lovibond and Lovibond (1995) constructed the Depression Anxiety Stress
Scale (DASS) in order to clearly distinguish the concept of strain as distinct from anxiety and

23
depression. Lovibond and Lovibond posit that strain (though they refer to it as stress) is
characterized by difficulty relaxing, nervous tension, irritability and agitation. This concept of
strain will consequently be referred to as tension.
The conceptualization of strain as arousing and producing tension is very different from
conceptualizations that view it as exhausting and leading to depletion. Borrowing from the
occupational health literature, burnout is viewed as an affective reaction to ongoing stress
whose core content is the gradual depletion over time of individuals intrinsic energetic
resources, including the expression of emotional exhaustion, physical fatigue, and cognitive
weariness (Shriom, 2003, p. 245). Some of the first conceptualizations of burnout came from
Maslach and her colleagues. According to the Maslach model, burnout consists of three
dimensions: emotional exhaustion, depersonalization, and reduced personal involvement
(Maslach, 1982; Maslach & Jackson, 1981; Maslach & Leiter, 1997, all cited in Shirom, 2003).
Emotional exhaustion is characterized by the depletion of ones emotional resources. This was
typically attributed as the central individual strain component. Depersonalization refers to the
interpersonal component of burnout, where people have negative or detached responses to
individuals around them. Reduced personal accomplishment is characterized by a persons
lowered self-efficacy.
However, the tripartite structure of burnout is not shared by all researchers and has been
revised in recent years. Building from the work of Maslach and her colleagues, the ShiromMelamed Burnout Measure (S-MBM) was presented by Shirom and colleagues (Shirom, 1989;
Shirom & Malamed, 2006). It was theoretically driven by Hobfolls (1989) conservation of
resource theory in that people are motivated to maintain and protect their resources, and threat

24
(or perceived threat) to those resources can result in strain. The conservation of resources stress
model posits that there are four main types of resources that are valuable: a) object resources
(e.g., a persons home), b) conditions (resources that are valued and sought after; e.g., being a
wife), c) personal characteristics (e.g., a personality trait), and d) energies (e.g., time, knowledge,
money). Stress is a consequence of these resources being threatened or somehow lost. According
to Shiroms conceptualization, burnout refers to energetic resources and thus represents a
combination of physical fatigue, emotional exhaustion, and cognitive weariness (Shirom, 2003,
p. 250). This concept of stress will consequently be referred to as depletion. Therefore, stress
conceptualized as both tension (arousing) and depletion (exhausting) was explored as potential
predictors of sexual and BDSM activity. Many studies have assessed how stressed people feel,
making it difficult to determine if people are experiencing less sexual activity from increased
tension or increased depletion. Therefore, the current study separately assessed tension and
depletion in order to disentangle the effects of strain on sexual activity.
Last, an individuals ability to cope with stressors plays an important role in the overall
impact of the stress response, including whether strain is experienced. According to the
transactional model of stress, coping is the process through which the individual manages the
demands of the person-environment relationship that are appraised as stressful and the emotions
they generate (Lazarus & Folkman, 1984, p. 19). Lazarus and Folkman (1984) presented two
kinds of coping: emotion-focused coping and problem-focused coping. Emotion-focused coping
is aimed at reducing the emotional distress caused by stressors and includes strategies such as
avoidance, minimization, distancing, selective attention, positive comparisons, and wresting
positive value from negative events (p. 150). This coping strategy is aimed at changing the way

25
the person responds to the stressor, namely, coping with the strain itself. In contrast, problemfocused coping is directed at defining the problem, generating alternative solutions, weighting
the alternatives in terms of their costs and benefits, choosing among them, and acting
[P]roblem-solving implies an objective, analytic process that is focused primarily on the
environment; problem-focused coping also includes strategies that are directed inward (p. 152).
As such, problem-focused coping is aimed at regulating the source of the stressor itself. If people
are experiencing strain, then they will be motivated to reduce and/or manage their responses to
stressors. Therefore, coping will also be explored as a variable of interest in the current study, as
it may be a mechanism by which sexual activity can serve as a response to reduce or manage
strain.
Main Hypotheses
Strain is inevitable in our everyday lives and can have dramatic effects on our personal
functioning. The experience of strain becomes especially important in long-term relationships,
particularly intimate relationships because of the amount and intensity of the interactions. The
amount of strain a person feels, either related to factors within the relationship or other life
events, can affect the way one interacts with ones partner, especially with respect to sexual
activity. By investigating the amount and type (i.e., tension or exhaustion) of strain a person
feels, and not just the amount of stressors, we can better understand how it impacts a persons
sexual desire and functioning.
First, it is predicted that BDSM status will moderate the relationship between tension and
sexual activity. Consistent with prior findings, for non-BDSM practitioners we expect that
increases in tension will lead to decreases in sexual activity. Previous research has indicated that,

26
for the most part, there exists a negative relationship between strain (typically using the
terminology stress) and sexual activity. Therefore, it is hypothesized that tension, as part of the
strain response, will be associated with decreases in sexual activity. A different pattern of results
is expected for BDSM practitioners, however (a main effect of sexual activity is also predicted;
see the discussion on Hypotheses 5 and 6). If Baumeisters (1988) escape from self theory is
correct, then we should expect that for people who identify as BDSM practitioners, specifically
masochists, increases in tension should lead to increased BDSM activity and sexual activity. For
individuals who identify as a submissive or a bottom, this would mean receiving orders,
receiving sensations from another, or letting someone else be in control. In this way, the use of
BDSM activity and subsequent increases in sexual activity (via sexual activity alone or in
conjunction with BDSM activity) are being used as a way to cope with tension. For masochists,
tension might represent an uncomfortable psychological state that motivates people to reduce this
discomfort by engaging in BDSM activity. (Different predictions might be made for tops, thus
BDSM role will be explored as a potential moderator of the association between tension and
sexual activity; see the discussion on Hypothesis 9.) Another pattern of results that could be
expected is that tension will have little effect on the BDSM and sexual activity of BDSM
practitioners. If this pattern of results is found, it might suggest that people use BDSM (and thus
sexual activity) more like a recreational hobby and that it is not tied to psychological needs to
reduce strain. Therefore, it is anticipated that strain will affect sexual activity of BDSM and nonBDSM practitioners in different ways.
However, it is also possible that tension will affect BDSM and sexual activity in a similar
pattern exhibited by previous research with non-BDSM practitioners; it might be that tension is

27
associated with lower levels of sexual activity for both BDSM practitioners and non-BDSM
practitioners alike. If these unexpected results are found, it would suggest that tension affects
BDSM and non-BDSM practitioners in a similar way.
Hypothesis 1a: BDSM status will moderate the relationship between tension and sexual
activity.
One pattern of sexual activity that might be the same for both BDSM and non-BDSM
individuals is the result of psychological depletion or burnout. When people are experiencing
psychological burnout, they may find it difficult to engage in a sexual interaction with their
partner, including everything from initially expressing sexual interest, initiating physical contact,
to actually being able to sexually enjoy an encounter. Especially within the BDSM partnership
where communication is so vital in maintaining and expressing consent, mental exhaustion could
be a challenge too great to overcome. Previous research has indicated that psychological strain is
negatively associated with sexual activity, and similar results are expected for both BDSM
practitioners and non-BDSM practitioners. This study will help illuminate whether tension and
depletion are different forms of strain that could lead to differential impacts on sexual activity.
Hypothesis 1b: The negative relationship between depletion and sexual activity will be
the same for BDSM practitioners and non-BDSM practitioners.
There is also a need to determine if there is a difference not only between the frequency
of sexual and BDSM activity for BDSM and non-BDSM individuals but also whether these
groups of interest endorse differing levels of desire for these behaviors. By exploring desire, in
addition to frequency, it is hoped to better understand whether desire (and not just sexual
activity) also gets reduced when people experience tension and/or depletion. Similar to

28
Hypotheses 1a and 1b, it is predicted that tension and depletion will affect the sexual desire of
the two groups differently. For both BDSM practitioners and non-BDSM practitioners, depletion
should reduce desire for sexual activity. A very different prediction could be made in regards to
tension. Previous research has demonstrated a positive relationship between daily hassle scores
and sexual desire (Morokoff & Gillilland, 1993). It is possible that daily hassles increase arousal
and thus predominantly affect the tension component of strain. Consequently, for both BDSM
and non-BDSM practitioners it is hypothesized that increases in tension will result in increased
sexual desire. However, this effect is expected to be greater among BDSM practitioners. One
reason for this might be that BDSM practitioners see sexual and/or BDSM activity as a way to
reduce tension, and therefore increases in tension could lead to increased desire for the behavior.
In conjunction with desire, sexual dysfunction and sexual satisfaction will also be
explored for those individuals who have actually engaged in sexual activity. Including a sexual
dysfunction scale further illuminated how strain impacts ones ability to enjoy sexual
experiences. Previous research has indicated that stress negatively impacts sexual functioning
(Bodenmann, Ledermann, Blattner-Bollinger, & Galluzzo, 2006; Morokoff & Gillilland, 1993).
Consistent with these findings, a negative relationship between strain (tension and depletion) and
sexual functioning is hypothesized. However, it is hypothesized that this relationship will be
attenuated in BDSM practitioners compared to non-BDSM practitioners. If BDSM practitioners
see sexual and BDSM activities as leisure activities (Newmahr, 2010), then it might be expected
that they would have less trouble reaching orgasm or becoming aroused while they are
experiencing strain. Furthermore, the current study also asked participants to rate their level of
satisfaction with their sexual and/or BDSM activities. There is mixed evidence in regards to how

29
stress impacts sexual satisfaction. Some findings have demonstrated that stress negatively
influences sexual satisfaction (Bodenmann, Ledermann, & Bradbury, 2007), whereas other
studies have found that once people had engaged in sexual activity, sexual satisfaction was not
affected by feelings of stress (Bodenmann, Atkins, Schr, & Poffet, 2010). The current study
hypothesizes that the association between strain and sexual satisfaction will be weak for nonBDSM practitioners. However, based on BDSM community definitions, it could be argued that
BDSM practitioners, compared to non-BDSM practitioners, place a higher value on sexual
intensity within their interactions with their partner (Brame, Brame, & Jacobs, 1993), and
therefore they might endorse greater satisfaction from engaging in sexual behavior. This study
will help to clarify how strain influences both desire and satisfaction.
Hypothesis 2a: For both non-BDSM practitioners and BDSM practitioners there will be a
negative relationship between depletion and sexual desire.
Hypothesis 2b: For both non-BDSM practitioners and BDSM practitioners there will be
a positive relationship between tension and desire, although the effect will be stronger
among BDSM practitioners.
Hypothesis 3a: There will be a negative relationship between tension and sexual
functioning; however, this effect will be attenuated in BDSM practitioners.
Hypothesis 3b: There will be a negative relationship between depletion and sexual
functioning; however, this effect will be attenuated in BDSM practitioners.
Hypothesis 4a: BDSM status will moderate the relationship between tension and sexual
satisfaction.

30
Hypothesis 4b: BDSM status will moderate the relationship between depletion and sexual
satisfaction.
Given the emphasis placed on eroticism within the BDSM community, which is
evidenced by community definitions and the explanations for BDSM behavior, and consistent
with the findings from Cross and Matheson (2006), it is expected that BDSM practitioners will
indicate engaging in greater amounts of sexual activity when compared to non-BDSM
practitioners. One of the goals of this study was to investigate how much overlap exists between
the use of BDSM behavior and sexual activities. As previously discussed, sexual
arousal/pleasure may be one of the primary effects of engaging in BDSM behavior, but it is not
always the case (Moser & Kleinplatz, 2006; Weinberg, Williams, & Moser, 1984; Wiseman,
1996). Furthermore, the connection between sexual and BDSM activity may change depending
on an individuals type of strain (tension or depletion). In order to shed light on the relationships
between strain and sexual activity and strain and BDSM activity, this study asked participants to
respond to questions about various category combinations of sexual and BSDM activities they
engaged in over the past week. For example, this study asked about sexual and BDSM behavior
that people engaged in on their own, without a partner. Similar to individual sexual behavior
(masturbation), BDSM can also be a solitary erotic behavior (Weinberg & Kamel, 1983);
therefore, this study investigated whether BDSM solitary behavior can also be non-sexual. The
category combinations people responded to depended on their interest in these activities. As
previously discussed, this study used a behavioral self-definition of BDSM activity, and
similarly, a behavioral self-definition of sexual activity was also used.

31
Hypothesis 5: BDSM practitioners will engage in more sexual activity than non-BDSM
practitioners.
Hypothesis 6: There will be a strong association between BDSM activity and sexual
activity for BDSM practitioners that will be evidenced by a higher proportion of BDSM
activity that is also sexual compared to BDSM activity that is non-sexual.
Explanatory Variables
One potential reason that might explain the different relationship between tension and
sexual activity for BDSM practitioners and non-BDSM practitioners is that BDSM practitioners
have greater overall levels of tension, which could potentially drive them to engage in these
types of activities. However, there is not any evidence in the literature to suggest that BDSM
practitioners experience strain (either within or outside the relationship) to a greater degree than
non-BDSM practitioners; therefore, we expect that mean levels of strain will be the same for
both populations.
Hypothesis 7: BDSM practitioners and non-BDSM practitioners will not exhibit a
difference in their perceived tension or depletion.
Additionally, this research sought to determine if BDSM and non-BDSM practitioners
differ in their use of coping strategies. It could be argued that the escape from self theory
(Baumeister, 1988) is an avoidance coping strategy; therefore, this study asked participants to
respond to a coping strategies scale in order to determine if BDSM practitioners have a greater
general tendency to use avoidance strategies in response to strain than non-BDSM practitioners.
If there are group differences on avoidance coping strategies, it would suggest that BDSM
practitioners prefer avoidance mechanisms to a greater degree than non-BDSM practitioners and

32
that BDSM activity could represent one such avoidance mechanism. If there are no group
differences on avoidance found between BDSM practitioners and non-BDSM practitioners, it
would provide support that BDSM practitioners do not differ from non-BDSM practitioners in
terms of their tendency to use avoidance strategies. Non-significant group differences would
further suggest that there are other reasons that people seek out BDSM behavior (such as a
leisure activity).
Hypothesis 8: No group differences between BDSM practitioners and non-BDSM
practitioners should exist when comparing the use of coping strategies.
Exploratory Variables
This study also investigated BSDM role as a potential moderator of the relationships
between strain (tension and depletion) and sexual activity, desire, and satisfaction. Alternate
patterns of sexual activity could be demonstrated by the different roles BDSM individuals hold.
For example, perhaps increases in tension will lead to increases in sexual activity only for
bottoms, particularly masochists, but not for tops or sadists. One reason for this might be that as
directors of the sensations for bottoms, tops might actually experience an increase in strain (by
increased arousal and therefore tension) thinking of engaging in any BDSM activity and having
to be in control of another person. The reverse pattern, however, for tops could also be true;
perhaps people would seek out topping behavior in order to reduce their mental strain. It could
be argued that tops find giving sensations and/or controlling another person to be very mentally
gratifying. Finally, switches represent a very interesting case because they take on both top and
bottom roles, and their level of tension may lead them to engage in one role over another.
Therefore, BDSM role was explored as a potential moderating variable of the relationship

33
between strain (tension and depletion) and sexual and/or BDSM activity. Additionally,
participants were asked to describe the sexual and BDSM activities they engaged in over the last
week. These answers provided further information about the intensity (as well as type) of
activities which will be used to better understand how stress impacts the behaviors people engage
in.
Hypothesis 9: BDSM role will moderate the relationship between strain (tension and
depletion) and sexual and/or BDSM activity for BDSM practitioners.
Finally, this research investigated whether motivations for sex differ across BDSM
individuals and non-BDSM individuals, and it will be of particular interest to see how these
motivations are different (or similar) between tops and bottoms. It is anticipated that BDSM and
non-BDSM practitioners will endorse different motivations and that tops and bottoms will also
endorse different motivations.
Hypothesis 10: The sexual motivations for non-BDSM practitioners will be different than
those of BDSM practitioners, and within BDSM practitioners, tops and bottoms will also
have different sexual motivations.
Last, relationship satisfaction and self/other overlap will also be explored as additional
moderators. Previous research has demonstrated that relationship satisfaction can moderate the
strain and sexual activity relationship (Bodenmann et al., 2007; Ein-Dor & Hirschberger, 2012).
Self/other overlap may provide an additional way to conceptualize relationship satisfaction that
could moderate the association between strain and sexual activity.
Hypothesis 11: Relationship satisfaction and self-other overlap will moderate the
relationship between strain (tension and/or depletion) and sexual and/or BDSM activity.

CHAPTER 2
METHOD
Participants and Procedure
Multiple methods were employed to recruit specifically from the BDSM community.
First, emails with information about the study were sent out to Northern Illinois Universitys
BDSM research group mailing list. The BDSM mailing list is composed of individuals who have
previously agreed to be contacted about SM- related research and research opportunities. The
email contained a brief description of the study and its purpose along with a link to the survey.
Second, the BDSM research group maintains a profile on FetLife, a social networking site for the
BDSM community, and information about the study and how to participate (a link) was posted
via a discussion thread. Participation from the BDSM community was completely voluntary.
MTurk was mainly utilized to acquire the non-BDSM participants, although it was
expected that some MTurk users would identify as someone who engages (or has previously
engaged) in BDSM activity. Interested MTurk users followed a link to the survey via the MTurk
website. MTurk participants received monetary compensation ($1.00) for their participation
within one week of survey completion.
Word of mouth was also used to recruit participants; interested individuals were given a
flier with information about the study and a link to participate. SurveyMonkey.com was used to

35
host the survey, and all information collected was anonymous. The survey consisted of multiple
scales and demographic questions and took between 30 minutes and one hour to complete.
A total of 291 people began the survey; however, 14 people dropped out before
responding to the demographics questions, so these cases were removed. Another 23 people were
removed for failing to respond to both the tension and depletion scales (the IVs of interest), and
another 27 failed to respond to the BDSM self-identity classification question at the end of the
survey, leaving 227 cases to analyze (130 women, 94 men, 3 not listed or missing; Mage= 34.27,
SD=11.32, 18-69). The majority of respondents were Caucasian (77.5%, 7.0% AfricanAmerican, 4.8% Asian-American, 3.1% Bi-racial, 3.1% Hispanic/Latino, .9% Middle Eastern,
3.5% not listed or missing), and heterosexual (80.6%, 12.8% bisexual, 4.0% gay/lesbian, 2.6%
not listed). A little over half of the respondents had a bachelors degree or higher (56.8%), 23.8%
had some college credit, 7.0% had earned a technical degree, 11.9% had a high school diploma,
and .4% had less than a high school diploma. In regards to religion or spiritual preference, 37.5%
was either Christian or Catholic, 48.7% said they had no religion or were agonistic or atheist,
3.5% self-identified as spiritual, and 9.7% was coded as other (e.g., Buddhist, Jewish, Muslim,
pagan, Wiccan, and Deist). A total of 86.8% of the sample identified as being married or in a
long-term committed relationship, whereas 8.8% listed their relationship status as casual, and
4.4% listed other (e.g., polyamorous, master/slave). The average length of relationships was 6.99
years (SD=8.07 years, 6 months - 47.92 years). Participant age and relationship length was
significantly positively correlated, r(212) = .62, p<.001.
To determine the classification of individuals as either a BDSM or non-BDSM
practitioner, four questions were used. The first three questions were designed to assess BDSM

36
behavior. Near the beginning of the survey, and after being shown instructions defining BDSM
behaviors (see Appendix A), individuals were first asked, Have you ever engaged in BDSM
activities with your partner? If a participant said no to this question, they were asked, Have
you engaged in BDSM activities in the past? and if the answer was still no, then, Have you
ever desired, or been interested in, BDSM activities? Finally, at the end of the survey, the last
question was designed to allow individuals to self-identify as a BDSM practitioner: Do you
identify as someone who engages in BDSM activities? If a participant responded no to all four
questions, they were classified as a Non-Practitioner (individuals who have never engaged in or
desired BDSM nor self-identify as a practitioner). If a participant said yes to both the first and
last question, they were classified as a Practitioner (someone who engages in BDSM activity
with ones partner and self-identifies as a practitioner). Finally, the Behaviorist group consisted
of individuals who said yes to at least one of the first three questions but no to the self-identify
question (someone who has engaged in BDSM behavior in the past or desired to but who does
not self-identify as a practitioner). Classifying individuals into these three groups resulted in 65
Practitioners, 79 Behaviorists, and 83 Non-Practitioners. A breakdown of the demographics by
this classification is included in Table 1.

37
Table 1
Demographic Variables by Group
Variable

Practitioners
(N=65)

Behaviorists
(N=79)

Non-Practitioners (N=83)

Gender
Women
37 (59.9%)
47 (59.5%)
46 (55.4%)
Men
26 (40.0%)
31 (39.2%)
37 (44.6%)
Not listed
2 (3.1%)
1 (1.3%)
Age (in years), M (SD)
34.60 (12.12)
32.76 (10.53)
35.45 (11.36)
Sexual Orientation
Heterosexual
39 (60.0%)
63 (79.7%)
81 (97.6%)
Bisexual
17 (26.2%)
10 (12.7%)
2 (2.4%)
Gay/Lesbian
4 (6.2%)
5 (6.3%)
Other/Missing
5 (7.7%)
1 (1.3%)
Ethnicity
African- American
3 (4.6%)
9 (11.4%)
4 (4.8%)
Asian-American
2 (3.1%)
4 (5.1%)
5 (6.0%)
Bi-racial
4 (6.2%)
2 (2.5%)
1 (1.2%)
Caucasian
47 (72.3%)
60 (75.9%)
69 (83.1%)
Hispanic/Latino
2 (3.1%)
3 (3.8%)
2 (2.4%)
Middle Eastern
1 (1.5%)
1 (1.2%)
Not listed
5 (7.7%)
1 (1.3%)
1 (1.2%)
Religion
Christian/Catholic
16 (24.6%)
32 (40.6%)
37 (44.6%)
None/Atheist/Agnostic
31 (47.7%)
40 (50.6%)
38 (45.8%)
Spiritual
5 (7.7%)
2 (2.5%)
1 (1.2%)
Other
10 (15.4%)
5 (6.3%)
7 (8.4%)
Missing
3 (4.6%)
Education
Bachelors or higher
39 (60.0%)
39 (49.4%)
51 (61.4%)
Some college credit
15 (23.1%)
27 (34.2%)
12 (14.5%)
Technical degree
5 (7.7%)
2 (2.5%)
9 (10.8%)
HS diploma
5 (7.7%)
11 (13.9%)
11 (13.3%)
Less than HS diploma
1 (1.5%)
Relationship status
Committed long-term
49 (75.4%)
68 (86.1%)
80 (96.4%)
Casual
7 (10.8%)
10 (12.7%)
3 (3.6%)
Other
9 (13.8%)
1 (1.2%)
Relationship length
5.76 (6.74)
6.85 (7.81)
8.10 (9.17)
(in years) M (SD)
Note. Frequency quotes unless noted by M (SD). One-way ANOVAs showed no group
differences on age or length of relationship.

38
Materials
Demographics
Individual demographic questions assessed gender, sexual orientation, age, ethnicity,
educational achievement, and religion. Relationship demographic questions such as relationship
length, relationship status, co-habitation, and children were also asked. Please see Appendix A
for the complete list of demographic questions. At the end of the survey, participants were asked
further questions about their relationship and relationship experience (see Appendix J for these
questions).
After the basic demographic questions, participants were asked a series of questions to
assess the types of activities they engage in with their partner (see Appendix A). The answers
that participants provided to these questions determined the types of activity questions
participants were shown later in the study (see Appendix E).
First, participants were asked to read a description of sexual activity and asked if they
have ever engaged in sexual activities with their partner. If participants said yes, then they
were later asked about their sexual behavior during the past week. If they had not engaged in
sexual activities with their current partner, they were asked if they had ever engaged in sexual
activities in the past. If they said yes to this question, then participants were asked questions
regarding sexual behavior later in the study. If participants said no to both engaging in sexual
behavior with their current partner and to engaging in sexual activities in the past, then they were
not asked any questions later in the study regarding sexual activities during the past week.
Second, participants were shown a description of BDSM activities (see Appendix A). It was
clearly stated in the prompt that many people may not refer to these behaviors or activities using

39
the terminology BDSM. This was done to be both inclusive as possible and combat the
stigmatization that the term BDSM might hold for some individuals. The same process as the
sexual activity questions was repeated. If a participant said yes to having engaged in BDSM
activities at any point during this step, then they were asked to respond to the BDSM role
preferences questions.
Tension
The Stress subscale of the Depression Anxiety Stress Scale (DASS; Antony, Bieling,
Cox, Enns, & Swinson, 1998; Lovibond & Lovibond, 1993, 1995) was used to examine the
degree of strain felt by a participant. The Stress subscale is composed of 14 items and example
items include, I found it difficult to relax and I felt that I was using a lot of nervous energy
(please see Appendix B for the complete items). Individuals were asked to indicate how much
each statement applied to them over the last week using a 4-point scale (0= Did not apply to me
at all, 1= applied to me to some degree, or some of the time, 2= applied to me a considerable
degree, or a good part of the time, 3= applied to me very much, or most of the time). The internal
consistency of the Stress subscale of the DASS has been previously reported as .90 (Lovibond &
Lovibond, 1993), and in the current study it was .95.
Depletion
The Shirom-Melamed Burnout Measure (SMBM; Shirom & Melamed, 2006) measured
participants level of depletion over the previous week. The SMBM is a 14- item scale typically
used to measure burnout at work, but for the purpose of this study it was adapted to measure
burnout in a more general sense. The SMBM measures three components of burnout: Physical

40
fatigue, Cognitive weariness, and Emotional exhaustion. An example item of Physical fatigue is,
I feel burned out, and an example of Cognitive weariness is, I feel I am not thinking clearly.
Original items of Emotional exhaustion were written to refer to coworkers and customers, but in
this study they referred to being surrounded by others in a more general sense, for example: I
feel I am unable to be sensitive to the needs of those around me (please see Appendix C for the
complete items). Participants were instructed to report how often they have felt these feelings
over the last week using a 7-point scale (1= never or almost never, 2= very infrequently, 3=
quite infrequently, 4= sometimes, 5= quite frequently, 6= very frequently, 7= always or almost
always). The internal consistency of the SMBM has been previously reported as .92 (Shirom &
Melamed, 2006), and in the current study it was .96.
Coping
The Avoidance subscale of the Coping Strategy Indicator (CSI; Amirkhan, 1990;
Desmond, Shevlin, & MacLachlan, 2006) assessed participants tendency to use avoidance
coping strategies while going through a stressful event in the past week using a 3-point scale (0=
not at all, 1= a little, 2= a lot). Avoidance items include, Buried yourself in a hobby or sports
activity to avoid the problem and Wished that people would just leave you alone. Previous
research has found the internal consistency for the Avoidance subscale to be .84, and test-retest
correlations range from .77 to .86 (Amirkhan, 1990). Cronbachs alpha in the current study was
.84. Please see Appendix D for the complete items.

41
Physical, Sexual, and BDSM Activity
This section assessed the physical, sexual, and BDSM behavior that participants engaged
in during the previous week (see Appendix E). There were seven categories of behaviors that
participants could potentially respond to: Affectionate Behavior with Another Person, Sexual
Activity with Self, Sexual Activity with Another Person, BDSM Non-Sexual Activity with Self,
BDSM Sexual Activity with Self, BDSM Non-Sexual Activity with Another Person, and BDSM
Sexual Activity with Another Person. The number of categories participants responded to was
determined by the answers participants provided during the first demographic section; however,
every participant was asked questions regarding affectionate behavior. For example, if a person
said they had engaged in both sexual and BDSM activities with their partner, they were shown
all seven activity category questions. Or, if a person said they had engaged in sexual activities
with their partner but never BDSM activities (with their partner or in the past), then they were
only shown three categories: Affectionate Behavior, Sexual Activity with Self, and Sexual
Activity with Another Person.
Within each activity category and throughout the questions within that category, a
description of the behavior was provided. A total of seven questions were asked within each
activity category (with the exception of initiation and activity outside of the primary relationship
for any category that asks about activity with oneself). The first question asked about the
frequency of the behavior during the last week using a 7-point scale (0= never during the last
week, 1= 1 time, 2= 2 times, 3= 3 times, 4= 4 times, 5= 5 times, 6= 6 or more times). If any
option other than 0 was selected for the previous frequency question, five related questions
would follow which assessed the a) total number of days over which the activities happened, b)

42
degree of initiation of the activities between one and ones partner using a 7-point scale (-3= my
partner initiated all the activities, -2= my partner initiated most of the activities, -1= my partner
initiated somewhat more of the activities, 0= my partner and I initiated an equal number of the
activities, 1= I initiated somewhat more of the activities, 2= I initiated most of the activities, 3= I
initiated all of the activities), c) satisfaction with the activities using a 5-point scale (0= not at
all satisfied, 2= somewhat satisfied, 4= extremely satisfied), d) actual activities participants
engaged in (described in an open-ended format), and e) whether any of these times include
someone other than the primary partner (yes or no). Finally, the seventh question determined
desire for the behavior, regardless of whether or not the person had actually engaged in the
behavior during the last week, using a 5-point scale (0= did not desire at all, 2= somewhat
desired, 4= very much desired).
Sexual Dysfunction
The Arizona Sexual Experience Scale (ASEX; McGahuey, Gelenberg, Laukes, Moreno,
Delgado, McKnight, & Manber, 2000) is a short, five-item scale that measures sexual
dysfunction. This scale was only shown to participants who claimed they had engaged in sexual
activities with their partner during the last week. There are two forms of the scale, a version for
men and a version for women. The items are phrased as questions, and participants are asked to
respond using a 5-point scale, which changes depending on the question prompt. Both versions
for men and women assess sex drive, ease of arousal and orgasm, and satisfaction with orgasm.
An example item includes, How strong is your sex drive? with response options ranging from
no sex drive (1) to extremely strong (6), where all points are labeled. The version for men asks
about ease and maintenance of an erection, whereas the version for women asks how easily a

43
womans vagina becomes wet or moist during sex. The internal consistency of the ASEX has
been reported to be .91, and it has also shown good test-retest reliability (McGahuey, Gelenberg,
Laukes, Moreno, Delgado, McKnight, & Manber, 2000). In the current study Cronbachs alpha
was .86. Please see Appendix F for the complete items.
Sexual Motivation
The Affective and Motivational Orientation Related to Erotic Arousal Questionnaire (Hill
& Preston, 1996) measures eight different motivations for sex. However, for the purposes of this
study, only three motivations were measured: Relief from Stress (10 items), Enhancement of
Power (10 items), and Experience the Power of Ones Partner (10 items). Participants were asked
to rate how true or characteristic each statement is of them using a 5-point scale ranging from not
at all true (1) to moderately true (3) to completely true (5). An example item of the Relief from
Stress is, I often have a strong need to fantasize about sex or to do something sexual when I feel
upset or unhappy. An example item from the Enhancement of Power subscale is, I really enjoy
having sex as a way of exerting dominance and control over my partner, and an example from
the Experience the Power of Ones Partner subscale is, I am especially excited by the feeling of
domination and being controlled by my partner during sex and sexual fantasy. The internal
consistencies of the subscales have been reported in the range of .76 to .93, and all of the
subscales have been found to positively correlate with each other (Hill & Preston, 1996). In the
current study, Cronbachs alpha was .96 for Relief from Stress, .95 for Experience the Power of
Ones Partner, and .94 for Enhancement of Power. Please see Appendix G for the complete
items.

44
Relationship Satisfaction
The Relationship Assessment Scale (RAS; Hendrick, 1998) was used to assess
participants satisfaction with their partner. It is composed of seven question prompts, and
participants are asked to answer each question using a 5-point scale, where the response options
change depending on the prompt. For example, How good is your relationship uses poor (1),
average (3), and excellent (5), whereas How much do you love your partner uses not much (1),
average (3), and very much (5). Previous research has reported Cronbachs alpha for this scale to
be .86 (Hendrick, 1998), and in the current study it was .88. Please see Appendix H for the list of
items.
Self/Other Overlap
To measure relationship closeness, participants were asked to rate the degree to which
their concept of self overlaps with their concept of their romantic partner using the Inclusion of
Other in the Self Scale (IOS; Aron, Aron, & Smollan, 1992; Aron, Aron, Tudor, & Nelson,
1991). Participants were shown seven sets of overlapping circles representing various degrees of
self/other overlap and asked to choose the one that best describes their relationship. The IOS has
been shown to have good test-retest reliability and to positively correlate with other scales that
measure relationship closeness (Aron, Aron, & Smollan, 1992). Please see Appendix I for the
graphical representation of this scale.

CHAPTER 3
RESULTS
Preliminary Computations and Analyses
Composite scores were created for both the DASS (subsequently referred to as tension)
and Burnout (subsequently referred to as depletion) measures given the acceptable levels of
internal reliability. Additionally, the three subscales of the original Burnout measure, Physical
Exhaustion, Cognitive Weariness, and Emotional Exhaustion, were all significantly correlated
with each other above .60, ps < .001. The composite variables of tension (M = 1.86, SD = .70)
and depletion (M = 3.19, SD = 1.41) were significantly positively correlated, r(227) = .737, p <
.001.
A visual inspection of the histogram of tension indicated that the variable was positively
skewed, and the P-P plot also showed that many of the data values deviated away from the
diagonal. The z-score of skewness was 4.86 and the z-score of kurtosis was .35. A visual
inspection of the histogram of depletion showed that the variable had a slight positive skewness,
and the P-P plot showed a small number of data values deviating away from the diagonal. The zscore of skewness was 1.54 and the z-score of kurtosis was 2.34. Tension, D(227) = .11, p <.001,
and depletion, D(227) = .08, p <.01, were both significantly non-normal. Additionally, for
tension, the variances between the three groups were significantly different, F(2, 224) = 3.05, p
=.05, but this was not the case for depletion, F(2, 224) = .24, p =.79.

46
BDSM Status as a Moderator of the Relationship between Strain and Sexual Activity
Hypothesis 1a (tension) and 1b (depletion) proposed that BDSM should moderate the
effect of strain on sexual activity. In order to create the dependent variable total sexual activity,
Practitioners and Behaviorists total frequency of sexual activity with others and sexual BDSM
activity with others was first summed. If the summed variable resulted in a value higher than 7
(the maximum number on the original scale which corresponded to 7 or more times during the
past week) the variable was truncated to 7. This was to maintain comparability with the NonPractitioners group in that each group could not score past the maximum value on the scale. Past
research had found a negative relationship between stress and sexual activity, and this effect was
expected to be replicated in this study. Across the entire sample, tension and total sexual activity
were negatively correlated r(227) = -.14, p < .05, as well as depletion and total sexual activity,
r(227) = -.15, p < .05, supporting past research (see Table 2).
Table 2
Correlations and Means/Standard Deviations among Tension, Depletion, and Dependent Measures
M

SD

1. Tension

1.86

0.70

2. Depletion

3.19

1.41

.74*

3. Total Sexual

2.58

2.22

-.14*

-.15*

4. Sexual Desire

3.07

1.34

-.07

-.04

.44*

5. Sexual Functioning

4.28

1.03

-.21*

-.32*

6. Sexual Satisfaction

4.09

1.00

-.30*

7. Relationship

4.05

.78

Satisfaction
8. Self-other Overlap

4.94

1.56

.40*

.43*

-.39*

.38*

.25*

.43* -

-.30*

-.35*

.29*

.18*

.27*

.55*

-.22*

-.31*

.10

.10

.16*

.29*

.54*

Activity

Note. *Statistically significant (p < .05)

47
To investigate the moderating effect of BDSM group status on the relationship between
strain and sexual activity, two sets of moderated regression analyses were conducted (one for
tension and one for depletion as the independent variable). In order to compare the three groups,
three pairs of dummy codes and interaction terms were created. Each pair of dummy codes did
two comparisons. For example, the first pair compared Practitioners to Behaviorists and
Practitioners to Non-Practitioners. In each regression analysis the centered IV was entered on the
first step, pairs of dummy codes were entered on the second step, and the interaction terms were
entered on the third step. This same type of analysis was used in subsequent sections substituting
different dependent variables.
In regards to the effect of tension on total sexual activity (vanilla sex and sexual BDSM
activity combined), the omnibus interaction between BDSM group and tension was marginally
significant, F(2, 221) = 2.82, p = .06, R2 = .02. For the relationship between tension and total
sexual activity, the difference between Practitioners and Behaviorists was significant, b = 1.09,
SEb = .50, t(221) = 2.17, p = .03. The difference between Practitioners and Non-Practitioners was
also significant, b = 1.13, SEb = .55, t(221) = 2.05, p = .04, but the difference between
Behaviorists and Non-Practitioners was non-significant, b = .04, SEb = .48, t(221) = .08, p = .94.
Figure 1 graphs the slopes of tension predicting total sexual activity (vanilla sex and sexual
BDSM activity) for Practitioners, Behaviorists, and Non-Practitioners. As evidenced by the
figure, tension significantly negatively predicted sexual activity only for Practitioners.
Furthermore, these same analyses were conducted with the dependent variable of vanilla sex
only (a colloquial term used in the BDSM community meaning sexual activity without a BDSM
component; statistically, the frequency of sexual BDSM activity has been removed) and the same

48
results were found. Thus, support was found in regards to Hypothesis 1a, which stated that
BDSM status would moderate the relationship between tension and sexual activity.

Figure 1: Effect of Tension on Total Sexual Activity by Group


Note. Only the slope for Practitioners was significant, b = -1.34, p = .001.

Hypothesis 1b stated that the relationship between depletion and total sexual activity for
BDSM and non-BDSM practitioners would be the same. BDSM status did moderate the
relationship between depletion and sexual activity, as the omnibus interaction was significant,
F(2, 221) = 3.97, p =.02, R2 = .03. The difference between Practitioners and Behaviorists was
significant, b = .72, SEb = .26, t(221) = 2.81, p = .005. The difference between Practitioners and
Non-Practitioners was marginally significant, b = .48, SEb = .26, t(221) = 1.86, p = .064, but the

49
difference between Behaviorists and Non-Practitioners was non-significant, b = -.24, SEb = .23,
t(221) = -1.02, p = .31. Figure 2 graphs the slopes of depletion predicting total sexual activity
(vanilla sex and sexual BDSM activity) for Practitioners, Behaviorists, and Non-Practitioners. As
can be seen by the graph, an increase in depletion was strongly associated with reductions in
total sexual activity for Practitioners and to a lesser degree Non-Practitioners, but there was no
association between depletion and total sexual activity for Behaviorists. And again, these
analyses were conducted using vanilla sex only as the dependent variable and similar results
were found. Thus, Hypothesis 1b was not supported; the relationship between depletion and total
sexual activity was not the same for all three groups.

Figure 2: Effect of Depletion on Total Sexual Activity by Group


Note. The slope for Practitioners was significant, b = -.76, p < .001; the slope for Behaviorists
was non-significant, b = -.04, p = .80, and marginally significant for Non-Practitioners, b = -.28,
p = .10.

50
BDSM Status as a Moderator of the Relationship between Strain and Sexual Desire
Hypothesis 2a proposed that there would be a negative relationship between depletion
and sexual desire for both non-BDSM practitioners and BDSM practitioners. In other words, it
was predicted that BDSM status would not moderate the relationship between depletion and
sexual desire. Hypothesis 2b proposed that there would be a positive relationship between
tension and sexual desire and that the effect would be stronger among BDSM practitioners; thus,
it was predicted that BDSM status would moderate the relationship between tension and sexual
desire. To investigate the moderating effect of BDSM group status on the relationship between
strain and sexual desire, two moderated regression analyses were conducted (one for depletion
and one for tension as the independent variable). The dependent variable sexual desire represents
Practitioners and Behaviorists average desire for both vanilla sex and sexual BDSM activity
and Non-Practitioners average desire for vanilla sex.
The omnibus interaction between depletion and BDSM status on total sexual desire was
non-significant, F(2, 221) = .30, p =.75, R2 = .002, and none of the differences between the
groups were significant. Depletion did not predict total sexual desire for Practitioners,
Behaviorists, or Non-Practitioners. These same results were found looking at the effect of
depletion on desire for vanilla sex alone. Thus, Hypothesis 2a predicted that there would be a
negative relationship between depletion and sexual desire, but this was not supported by these
results which showed that depletion was not related to sexual desire.
The omnibus interaction between tension and BDSM status on total sexual desire was
also non-significant, F(2, 221) = .43, p =.65, R2 = .003, and none of the differences between
Practitioners, Behaviorists, or Non-Practitioners were significant. Additionally, tension did not

51
significantly predict sexual desire for any of these three groups (or desire for just vanilla sex).
Thus, Hypothesis 2b, which stated that there would be a positive relationship between tension
and sexual desire for both BDSM Practitioners and Non-Practitioners, was not supported either.
BDSM Status as a Moderator of the Relationship between Strain and Sexual Functioning
Hypothesis 3a (tension) and Hypothesis 3b (depletion) predicted that there would be a
negative relationship between strain and sexual functioning, but the effect would be attenuated in
BDSM practitioners. In other words, it was predicted that BDSM status would moderate this
relationship. The dependent variable sexual functioning is represented by participants mean
score on the ASEX, in that a higher score indicated better sexual functioning. To investigate the
moderating effect of BDSM group status on the relationship between strain and sexual
functioning, two moderated regression analyses were conducted (one for tension and one for
depletion as the independent variable). Additionally, the analyses in this section were conducted
using only the people who had engaged in sexual activity during the last week.
The omnibus interaction between tension and BDSM status on sexual functioning was
marginally significant, F(2, 159) = 2.86, p =.06, R2 = .03. The difference between
Practitioners and Behaviorists was non-significant, b = .25, SEb = .25, t(159) = 1.00, p = .33, but
the difference between Practitioners and Non-Practitioners was significant, b = .68, SEb = .29,
t(159) = 2.35, p = .02. The difference between Behaviorists and Non-Practitioners was
marginally significant, b = .44, SEb = .26, t(159) = 1.71, p = .09. As can be seen in Figure 3, an
increase in tension was associated with a reduction in sexual functioning only for Practitioners
and Behaviorists but not Non-Practitioners. Thus, Hypothesis 3a was partially supported; BDSM
status did moderate the relationship between tension and sexual functioning but not in the

52
expected direction. The negative relationship between tension and sexual functioning was not
attenuated among BDSM practitioners but actually stronger; increases in tension led to reduced
sexual functioning for Practitioners and Behaviorists compared to Non-Practitioners.

Figure 3: Effect of Tension on Sexual Functioning by Group


Note. The slope for Practitioners was significant, b = -.64, p = .002, as well as the slope for
Behaviorists, b = -.39, p = .011. The slope for Non-Practitioners was non-significant, b = .05, p =
.82.

The omnibus interaction between depletion and BDSM status on sexual functioning was
not significant, F(2, 159) = .11, p=.90, R2 = .001, and the differences between the groups were
also not significant. However, as can be seen in Figure 4, an increase in depletion was associated
with a reduction in sexual functioning for all three groups. Thus, Hypothesis 3b was only
partially supported; increases in depletion were associated with reductions in sexual functioning

53
for BDSM practitioners as well as non-BDSM practitioners. BDSM status did not moderate this
relationship.

Figure 4: Effect of Depletion on Sexual Functioning by Group


Note. The slopes for Practitioners, Behaviorists, and Non-Practitioners were significant, b = -.32,
p = .001, b = -.27, p = .001, b = -.30, p = .002, respectively.

BDSM as a Moderator of the Relationship between Strain and Sexual Satisfaction


Hypothesis 4a (tension) and Hypothesis 4b (depletion) predicted BDSM status would
moderate the relationship between strain and sexual satisfaction. The dependent variable sexual
satisfaction represents the average satisfaction from vanilla sex and sexual BDSM activity for
both Practitioners and Behaviorists who engaged in sexual activity during the last week and the
average sexual satisfaction for Non-Practitioners who engaged in sexual activity during the last
week. Thus, the analyses in this section refer only to those who had engaged in sexual activity

54
during the previous week. Two moderated regression analyses (one for tension and one for
depletion as the independent variable) were conducted using sexual satisfaction as the dependent
variable.
The omnibus interaction between BDSM status and tension was marginally significant,
F(2, 159) = 2.97, p =.054, R2 = .03. The difference between Practitioners and Behaviorists
was non-significant, b = .39, SEb = .27, t(159) = 1.45, p = .15, as was the difference between
Behaviorists and Non-Practitioners, b = .36, SEb = .27, t(159) = 1.32, p = .19. The difference
between Practitioners and Non-Practitioners, however, was significant, b = .76, SEb = .31, t(159)
= 2.43, p = .016. As can be seen in Figure 5, tension was a significant predictor of a reduction in
sexual satisfaction for Practitioners and Behaviorists, but not Non-Practitioners. Thus,
Hypothesis 4a was mostly supported; BDSM status did moderate the relationship between
tension and sexual satisfaction.

Figure 5 : Effect of Tension on Total Sexual Satisfaction by Group


Note. The slope for Practitioners was significant, b = -.88, p < .001, as well as for Behaviorists, b
= -.48, p = .003, but it was non-significant for Non-Practitioners, b = -.12, p = .58.

55
In regards to depletion, the omnibus interaction with BDSM status was non-significant,
F(2, 159) = .65, p =.53, R2 = .007, and the differences between Practitioners, Behaviorists,
and Non-Practitioners were also non-significant. Figure 6 graphs the slopes of depletion
predicting sexual satisfaction (from vanilla sex and sexual BDSM activity) for Practitioners,
Behaviorists, and Non-Practitioners; depletion was associated with reductions in sexual
satisfaction for everyone. Therefore, Hypothesis 4b was not supported; BDSM status did not
moderate the relationship between depletion and sexual satisfaction. For everyone, increases in
depletion were associated with reductions in sexual satisfaction.

Figure 6 : Effect of Depletion on Total Sexual Satisfaction by Group


Note. The slopes for Practitioners, Behaviorists, and Non-Practitioners were significant, b =
-.42, p < .001, b = -.28, p = .003, and, b = -.29, p = .007, respectively.

56
Differences in Sexual Activity Frequency among BDSM Groups
Hypothesis 5 stated that BDSM practitioners would engage in more total sexual activity
than non-BDSM practitioners. Sexual activity was investigated two ways in order to better
understand how much BDSM sexual activity was accounting for BDSM practitioners total
sexual activity. First, a one-way ANOVA on total sexual activity revealed significant differences
between Practitioners, Behaviorists, and Non-Practitioners, F(2, 224) = 8.24, p < .001, 2p = .06.
Least significant difference (LSD) post hoc comparisons showed that Practitioners (M = 3.48, SD
= 2.46) engaged in significantly more total sexual activity compared to Behaviorists (M = 2.37,
SD = 2.10), p = .002, or Non-Practitioners (M = 2.08, SD = 1.93), p < .001 (see Table 3).
The second way that sexual activity was investigated was to compare the frequency of
vanilla sex between Practitioners, Behaviorists, and Non-Practitioners. A one-way ANOVA
analyzing vanilla sex resulted in no significant differences between Practitioners (M = 2.58, SD =
2.11), Behaviorists (M = 2.06, SD = 1.90), and Non-Practitioners (M = 2.08, SD = 1.93) on
vanilla sex, F(2, 224) = 1.55, p = .241, 2p = .01 (see Table 3). Taken together, the results
indicated that Practitioners, compared to Behaviorists and Non-Practitioners, were only engaging
in more sexual activity when sexual BDSM activity was also taken into account. Thus,
Hypothesis 5 was supported in regards to Practitioners but not Behaviorists.
Additionally, Hypothesis 6 posited that there would be a strong association between
BDSM activity and sexual activity in that practitioners would engage in more BDSM activity
with their partner that was also sexual compared to BDSM activity that was non-sexual. For
Practitioners, they did not engage in more sexual BDSM activity (M = 1.45, SD = 1.85) than
non-sexual BDSM activity (M = 1.18, SD = 2.01), t(65) = 1.18, p = .24. Additionally, sexual

57
Table 3
Independent and Dependent Measures by Group
Measure

Practitioners
(N=65)
Mean (SD)
1.89 (.66)a,b

Behaviorists
(N=79)
Mean (SD)
1.98 (.79)a

Non-Practitioners
(N=83)
Mean (SD)
1.72 (.62)b

Depletion

3.45 (1.32)a

3.31 (1.47)a

2.86 (1.39)

Vanilla Sex and Sexual


BDSM activity Combined
Vanilla Sex

3.48 (2.46)

2.37 (2.10)

2.58 (2.11)a

2.06 (1.90)a

2.08 (1.93)a

Sexual Desire

3.60 (1.17)a

2.51 (1.05)

3.23 (1.52)a

Sexual Functioning

4.54 (.92)a

4.34 (.85)a

4.44 (.99)a

Sexual Satisfaction

4.03 (1.04)a

4.03 (1.04)a

4.20 (.94)a

Relief from Stress

3.04 (1.20)a

2.75 (1.12)a,b

2.46 (1.16)b

Experiencing the Power of


Ones Partner
Enhancement of Power

3.44 (1.90)

3.03 (.99)

2.31 (.87)

2.92 (1.01)a

2.67 (1.03)a

2.17 (.88)

Avoidance Coping

1.79 (.46)a

1.70 (.48)a,b

1.60 (.43)b

Relationship Satisfaction

4.18 (.77)a

3.86 (.85)

4.13 (.70)a

Tension

Self-Other Overlap
4.72 (1.69)a
4.75 (1.53)a
5.29 (1.44)
Note. Means that share a superscript do not differ significantly from each other at p < .05.

58
BDSM activity and non-sexual BDSM activity were significantly positively correlated, r(65) =
.57, p < .001. Similar results were found for Behaviorists; they did not engage in more sexual
BDSM activity (M = .43, SD = .96) than non-sexual BDSM activity (M = .43, SD = 1.39), t(79) =
0, p = 1, r(79) = .32, p < .01. As evidenced by these results, however, Practitioners engaged in
more sexual BDSM activity and more non-sexual BDSM activity compared to Behaviorists,
t(142) = 4.25, p < .001, t(142) = 2.65, p < .01, respectively. Thus, Hypothesis 6 was not
supported; Practitioners and Behaviorists did not engage in more sexual BDSM activity than
non-sexual BDSM activity.
Differences in Tension and Depletion among BDSM Groups
To investigate whether there were differences between the three BDSM groups
(Practitioners, Behaviorists, and Non-Practitioners; Hypothesis 7) on tension and depletion, two
one-way ANOVAs were conducted. The first one-way ANOVA suggested a marginally
significant effect of group membership on tension, F(2, 224) = 3.01, p = .051, 2p = .03.
However, LSD post hoc comparisons revealed that only the difference between Behaviorists (M
= 1.98, SD = .79) and Non-Practitioners was significant (M = 1.72, SD = .62), p = .017 (see
Table 3).
The second one-way ANOVA revealed significant differences between Practitioners,
Behaviorists, and Non-Practitioners on depletion, F(2, 224) = 3.67, p = .027, 2p = .03. LSD posthoc comparisons showed that the differences between Practitioners (M = 3.45, SD = 1.32) and
Non-Practitioners (M = 2.86, SD = 1.39) was significant, p = .012, as well as Behaviorists (M =
3.31, SD = 1.47) and Non-Practitioners, p = .042 (see Table 3).

59
Hypothesis 7 stated that there would be no differences in overall tension or depletion
between BDSM practitioners and non- BDSM practitioners; however, it does appear that some
group differences exist. Behaviorists and Practitioners both had higher levels of tension and
depletion compared to Non-Practitioners.

BDSM Group Differences in Coping


Hypothesis 8 claimed that no group differences should exist when comparing avoidance
coping strategies. A composite score on avoidance coping was created, and a one-way ANOVA
was conducted to investigate groups differences. It was found that Practitioners (M = 1.79, SD =
.46), Behaviorists (M = 1.70, SD = .48), and Non-Practitioners (M = 1.60, SD = .43) differed in
their use of avoidance coping, F(2, 224) = 3.33, p =.037, 2p = .03. LSD post hoc comparisons
revealed that Practitioners endorsed more avoidance coping than Non-Practitioners but that
Behaviorists did not differ from Practitioners or Non-Practitioners (see Table 3). Thus,
Hypothesis 8 was not supported.
However, an exploratory analysis was conducted to determine if tension or depletion
predicted the use of avoidance coping. This was done to better understand if certain groups use
of the coping strategy was more or less associated with strain. The omnibus interaction between
tension and BDSM status was non-significant, F(2, 221) = .43, p =.65, R2 = .003, and the
differences between Practitioners, Behaviorists and Non-Practitioners were also non-significant.
However, tension significantly predicted increases in the use of avoidance coping for
Practitioners, Behaviorists, and Non-Practitioners, b = .36, p < .001; b = .33, p < .001; b = .41, p

60
< .001, respectively. Thus, it appears that tension is negatively associated with avoidance coping
for everyone.
In regards to depletion, and similar to tension, the interaction with BDSM status was nonsignificant, F(2, 221) = .07, p = .94, R2 = .000, as well as the differences between the groups.
But again similar to tension, depletion significantly predicted an increase in avoidance coping for
Practitioners, Behaviorists, and Non-Practitioners, b = .22, p < .001; b = .23, p < .001; b = .23, p
< .001, respectively. Taken together, these results suggest that, for everyone, increases in tension
and depletion are related to an increase in the use of avoidance coping.
BDSM Role as a Moderator of the Strain and Sexual Activity Relationship
Hypothesis 9 stated that BDSM role would moderate the relationship between strain
(tension and depletion) and sexual activity; thus BDSM role was investigated as a moderator of
the relationships between tension, depletion, and total sexual activity (vanilla sex and sexual
BDSM activity combined) within BDSM practitioners. In order to further investigate the
moderating effect of BDSM role within Practitioners, BDSM role was determined using two
methods. First, priority was given to the open-ended question, What BDSM role(s) do you take
on in your current relationship? that was included at the end of the survey. Second, when an
answer to an open-ended question was missing or ambiguous as to role (e.g., Patient, etc.), the
BDSM preferences questions were then used to help identify the preferred BDSM role. A total of
63 people responded to either the open-ended question or the preferences questions, resulting in
a total of 17 tops (5 women, 12 men), 24 bottoms (19 women, 4 men, one not listed), and 22
switches (12 women, 9 men, one not listed).

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First, the omnibus interaction between BDSM role and tension on total sexual activity
was non-significant, F(2, 57) = .269, p = .77, R2 = .008. For the relationship between tension
and total sexual activity, the difference between tops and bottoms was non-significant, b = -.76,
SEb = 1.20, t(57) = -.63, p = .53, as was the difference between tops and switches, b = -.84, SEb =
1.22, t(57) = -.69, p = .49, and bottoms and switches, b = -.09, SEb = 1.01, t(57) = -.08, p = .93.
Figure 7 graphs the slopes of tension predicting total sexual activity for tops, bottoms, and
switches. Although there was no significant interaction between tension and BDSM role, the
graph depicts how an increase in tension is marginally associated with a reduction in total sexual
activity for bottoms and switches but not for tops.

Figure 7: Effect of Tension on Total Sexual Activity by BDSM Role


Note. The slope for tops was non-significant, b = -.54, p = .59, but the slopes for bottoms and
switches were marginally significant, b = -1.29, p = .07, b = -1.38, p = .06, respectively.

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Second, these same regression analyses were conducted using depletion as the
independent variable. The overall omnibus interaction between depletion and BDSM role on
total sexual activity was also non-significant, F(2, 57) = .79, p = .46, R2 = .02. The difference
between tops and bottoms was non-significant, b = -.53, SEb = .52, t(57) = -1.02, p = .31, as was
the difference between tops and switches, b = -.59, SEb = .51, t(57) = -1.15, p = .26, and bottoms
and switches, b = -.06, SEb = .51, t(57) = -.11, p = .91. Figure 8 graphs the slopes of depletion
predicting total sexual activity for tops, bottoms, and switches. As can be seen in the graph,
depletion significantly negatively predicts total sexual activity for bottoms and switches but not
tops.

Figure 8: Effect of Depletion on Total Sexual Activity by BDSM Role


Note. The slope for tops was non-significant, b = -.37, p = .33, but the slopes for bottoms and
switches were significant, b = -.90, p = .02, and b = -.95, p = .01, respectively.

63
Taken together, these results provide little support for Hypothesis 9; BDSM role did not
seem to moderate the relationship between strain and total sexual activity. These results,
however, did provide some initial evidence to suggest that strain was influencing the sexual
activity of tops, bottoms, and switches differently. Therefore, exploratory analyses were
conducted to further investigate the effects of tension and depletion on the different types of
sexual activity (vanilla sex vs. sexual BDSM activity) between the BDSM roles.
First, two moderated regression analyses using tension as the IV and sexual BDSM
activity and vanilla sex as separate DVs were conducted. In regard to just sexual BDSM activity,
there was again no omnibus interaction between BDSM role and tension, F(2, 57) = .68, p =
.51, R2 = .02, and the differences between roles were non-significant as well. Tension was not a
significant predictor of sexual BDSM activity for bottoms or switches, but it was approaching
significance for tops, b = -1.23, p = .11. In regards to just vanilla sex, again the interaction
between BDSM role and tension was non-significant, F(2, 57) = .27, p = .77, R2 = .007, nor
were there any differences between roles. This time, however, tension significantly negatively
predicted vanilla sex for bottoms, b = -1.23, p = .04, and switches, b = -1.48, p = .02, but not for
tops. Thus, these results suggest that tension is more associated with a reduction in sexual BDSM
activity for tops, whereas tension seems more related to reductions in vanilla sex for bottoms and
switches.
Second, these same moderated regression analyses were conducted with depletion as the
independent variable and vanilla sex and sexual BDSM activity as separate dependent variables.
In regards to sexual BDSM activity, again the overall omnibus interaction between depletion and
BDSM role was non-significant, F(2, 57) = .43, p = .65, R2 = .01, and the differences between

64
roles were also non-significant. Depletion did significantly negatively predict sexual BDSM
activity for tops, b = -.59, p = .049, marginally so for switches, b = -.46, p = .11, but nonsignificantly for bottoms, b = -.24, p = .46. In regards to vanilla sex, the overall omnibus
interaction was non-significant, F(2, 57) = .56, p = .58, R2 = .01, as well as the differences
between roles. Depletion did significantly predict, however, reductions in vanilla sex for
bottoms, b = -.74, p = .02, and switches, b = -.89, p = .01, but not so for tops, b = -.44, p = .18.
These exploratory results suggest that strain was more closely associated with reductions
in sexual BDSM activity for tops. Conversely, for bottoms, strain was more closely associated
with reductions in vanilla sex. Switches seemed to be negatively impacted by both tension and
depletion; tension was more negatively related to vanilla sex, whereas depletion was related to
reductions in both sexual BDSM activity and vanilla sex.
Finally, an additional exploratory analysis examined the relationships between tension,
depletion and non-sexual BDSM activity. Although this study made no specific predictions about
non-sexual BDSM activity, it seemed relevant to investigate whether tension or depletion
predicted increases or decreases in this activity given some of the past theoretical justifications
for engaging in BDSM. For example, some might argue that increases in strain would only
increase the frequency of non-sexual BDSM activity but not sexual BDSM activity; however, the
evidence in this study did not support this. In regards to tension, the omnibus interaction with
BDSM role was not significant, F(2, 57) = .50, p = .61, R2 = .01, and the differences between
roles were not significant as well. Tension did not significantly predict non-sexual BDSM
activity in bottoms or switches, but for tops the negative coefficient was trending towards
significance, b = -1.09, p = .16. In regards to depletion, the omnibus interaction with BDSM role

65
was again non-significant, F(2, 57) = .06, p = .95, R2 = .001. Furthermore, the differences
between the roles were also non-significant, and depletion did not predict non-sexual BDSM
activity for tops, bottoms, or switches. Taken together, these results did not support the idea that
an increase in strain was associated with an increase (or decrease) in the frequency of non-sexual
BDSM activity, especially for bottoms.
Additional Exploratory Mean Differences between BDSM Roles
There was no significant difference between tops (M = 1.69, SD = .59), bottoms (M =
2.02, SD = .68), and switches (M = 1.90, SD = .69) on tension, F(2, 60) = 1.24, p = .30, 2p = .04.
Additionally, there was no significant difference between tops (M = 3.39, SD = 1.47), bottoms
(M = 3.51, SD = 1.25), and switches (M = 3.36, SD = 1.35) on depletion, F(2, 60) = .08, p = .93,
2p = .002.
Looking at the frequency of total sexual activity with a partner (vanilla sex and sexual
BDSM activity combined and truncated to 7 or more times in the last week); however, there was
a marginal significant difference between tops (M = 4.71, SD = 2.39), bottoms (M = 3.17, SD =
2.66), and switches (M = 3.09, SD = 2.02), F(2, 60) = 2.72, p = .07, 2p = .08. It was therefore of
interest to compare mean levels of vanilla sex and sexual BDSM activity. The omnibus ANOVA
for vanilla sex was marginal, F(2, 60) = 2.46, p = .09, 2p = .07, and LSD post hoc comparisons
revealed that only the difference between tops (M = 3.53, SD = 2.27) and bottoms (M = 2.08, SD
= 2.04) was significant, p = .03. Given the high number of male tops and female bottoms, this
effect was explored by gender as well, but the interaction between gender and BDSM role was
non-significant, F(2, 55) = .76, p = .47, 2p = .03.

66
When looking at just sexual BDSM activity, there was a significant difference between
tops (M = 2.53, SD = 2.32), bottoms (M = 1.25, SD = 1.39), and switches (M = .91, SD = 1.66),
F(2, 60) = 4.32, p = .02, 2p = .11. LSD post hoc comparisons showed that tops were having
significantly more sexual BDSM activity than bottoms or switches, p = .03, p = .01, respectively,
and bottoms and switches were not significantly different from each other.
Taken together, these results showed that tops were engaging in both more vanilla sex
and sexual BDSM activity than bottoms or switches but the mean levels of tension or depletion
did not differ across BDSM role.
BDSM Groups and Differences in Sexual Motivation
Hypothesis 10 posited that the sexual motivations would be different between individuals
who engage in BDSM and those who do not. Three one-way ANOVAs were conducted to
investigate group differences using composite subscale scores, and there were significant
differences between Practitioners, Behaviorists, and Non-Practitioners on Relief from Stress,
F(2, 224) = 4.70, p = .01, 2p = .04; Experiencing the Power of Ones Partner, F(2, 224) = 23.95,
p < .001, 2p = .15; Enhancement of Power, F(2, 224) = 11.68, p < .001, 2p = .09. Post hoc
comparisons are indicated in Table 3. Taken together, Practitioners and Behaviorists endorsed
these motivations to a greater degree than the Non-Practitioners. Thus, Hypothesis 10 was
supported.
Further exploratory analyses were conducted looking at the relationships between the
three subscales. The three sexual motivation subscales (Relief from Stress, Experiencing the
Power of Ones Partner, and Enhancement of Power) were significantly positively correlated
with each other, consistent with previous findings: Relief from Stress and Experiencing the

67
Power of Ones Partner, r(227) = .48, p < .001; Relief from Stress and Enhancement of Power,
r(227) = .52, p < .001; and Experiencing the Power of Ones Partner and Enhancement of Power,
r(229) = .42, p < .001. These positive correlations were also found when analyzed separately by
classification group, except for the correlation between Enhancement of Power and Experiencing
the Power of Ones Partner for Practitioners, r(65) = -.15, p = .24. This might have been due to
the fact that Practitioners often self-identify either as a top, bottom, or switch, thus likely making
their sexual motivation in regards to the experience of power different. Thus, separate
exploratory analyses using Practitioners were conducted.
There was not a significant difference between tops (M = 2.72, SD = 1.31), bottoms (M =
3.00, SD = 1.19), and switches (M = 3.31, SD = 1.11) on Relief from Stress sexual motivation,
F(2, 60) = 1.17, p = .32, 2p = .04. There was, however, a significant difference between tops (M
= 2.50, SD = 1.09), bottoms (M = 4.22, SD = .67), and switches (M = 3.46, SD = 1.10) on
Experiencing the Power of Ones Partner sexual motivation, F(2, 60) = 16.25, p < .001, 2p = .26.
LSD post hoc comparisons revealed that bottoms endorsed this motivation the most, followed by
switches, followed by tops. Similarly, there was a significant difference between tops (M = 3.70,
SD = .77), bottoms (M = 2.45, SD = .81), and switches (M = 2.93, SD = 1.02) on the sexual
motivation Enhancement of Power, F(2, 60) = 10.09, p <.001, 2p = .20. Simple effects revealed
that tops endorsed this motivation the most, followed by switches and bottoms who were only
marginally significantly different from each other. These results indicate that tops, bottoms, and
switches endorsed the sexual motivations in regards to the experience of power to different
degrees but not relief from stress.

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Relationship Satisfaction/Self-Other Overlap as Moderators of the Relationship between Strain
and Sexual Activity
Hypothesis 11 predicted that relationship satisfaction and/or self-other overlap would
moderate the relationship between strain (tension and depletion) and sexual activity. Relationship
satisfaction is represented by participants mean score on the RAS. Self-other overlap is
represented by participants mean score on the one-item IOS.
First, a moderated regression analysis looking at the omnibus interaction between tension
and relationship satisfaction on total sexual activity was non-significant, F(1, 223) = 2.33, p =
.13, R2 = .009, b = -.364, SEb = .24. However, relationship satisfaction did significantly
positively predict total sexual activity when controlling for tension, b = .829, SEb = .19, p < .001.
Second, the omnibus interaction between tension and self-other overlap on total sexual activity
was not significant, F(1, 223) = .09, p = .78, R2 = .000, b = -.038, SEb = .13, and self-other
overlap did not significantly predict total sexual activity after controlling for tension.
Second, similar analyses were conducted using depletion as the independent variable.
The omnibus interaction between relationship satisfaction and depletion was also nonsignificant, F(1, 223) = 1.92, p =.17, R2 = .008, b = -.157, SEb = .11. But again, after
controlling for depletion, relationship satisfaction was a significant predictor of total sexual
activity, b = .826, SEb = .20, p < .001. The omnibus interaction between depletion and self-other
overlap was not significant, F(1, 223) = .03, p = .86, R2 = .000, b = -.011, SEb = .06, nor was
self-other overlap a significant predictor of total sexual activity after controlling for depletion.

69
Taken together, these results did not provide support for Hypothesis 11, although the
interactions were trending towards significance. It was demonstrated, however, that relationship
satisfaction, more so than self-other overlap, was positively associated with sexual activity.
Given these results, it was of interest to explore BDSM status as an additional moderator
of that relationship. First, the omnibus three-way interaction between tension, BDSM status, and
relationship satisfaction was marginally significant, F(2, 215) = 2.39, p = .09, R2 = .02. The
difference between Practitioners and Behaviorists was significant, b = 1.58, SEb = .73, t(215) =
2.18, p = .03. The difference between Practitioners and Non-Practitioners was just above
marginal significance, b = 1.4, SEb = .84, t(215) = 1.64, p = .10. Finally, the difference between
Behaviorists and Non-Practitioners was not significant, b = -.21, SEb = .62, t(215) = -.34, p = .74.
For Practitioners, there was a significant interaction between relationship satisfaction and
tension, b = -1.53, p = .02. For Behaviorists, the interaction between relationship satisfaction and
tension was non-significant, b = .05, p = .87. Last, the two-way interaction between tension and
relationship satisfaction was non-significant for Non-Practitioners as well, b = -.16, p = .76.
These results show that relationship satisfaction moderated the relationship between tension and
total sexual activity only for Practitioners.
Next, similar analyses were conducted with depletion. The omnibus interaction with
depletion, BDSM status, and relationship satisfaction on total sexual activity was significant, F
(2, 215) = 3.57, p =.03, R2 = .03. The difference between Practitioners and Behaviorists was
significant, b = .87, SEb = .33, t(215) = 2.66, p = .01, and the difference between Practitioners
and Non-Practitioners was marginally significant, b = .622, SEb = .36, t(215) = 1.71, p = .09.
Finally, the difference between Behaviorists and Non-Practitioners was non-significant, b = -.25,

70
SEb = .27, t(215) = -.94, p = .35. Similar to the results of tension, there was a significant two-way
interaction between depletion and relationship satisfaction only for Practitioners, b = -.77, p =
.01. Taken together, these results show that only Practitioners relationship satisfaction
moderated the relationship between strain and total sexual activity.

CHAPTER 4
DISCUSSION

The purpose of this study was two-fold: a) to separate the concept of stress into tension
and depletion to better understand their individual effects on sexual activity and related variables
and b) to compare these effects between BDSM practitioners and non-practitioners. To briefly
summarize, the findings in this study demonstrated that tension and depletion were associated
with the outcome variables in different ways, and furthermore, BDSM practitioners and nonpractitioners responded both similarly and differently to tension and depletion. Separating
tension and depletion allowed for a more nuanced understanding of how strain influenced
individuals sexual experiences and provided some explanation for previous research
demonstrating a negative relationship between stress and sexual activity; it appears that
depletion, rather than tension, is likely more responsible for this finding. BDSM status was also
found to moderate the relationship between strain and sexual activity, indicating that group
categorization may influence the way people respond to strain and their approach to sexual
behavior.
Conceptualizing Stress as Strain
In this study, the variable of primary interest --stress-- was conceptualized as strain. The
strain response was separated into two components: tension and depletion. Tension was

72
conceptualized as the arousing part of the strain response. Increases in tension are most likely
associated with feelings of high arousal, difficulty relaxing, and agitation or irritability.
Conversely, depletion was conceptualized as the low- energy response to strain, or feeling
emotionally and physically exhausted. This conceptualization of strain represents a shift from the
ambiguous experience of feeling stressed into a more nuanced understanding of how tension
and depletion can influence various outcome variables differently. In the past, much research has
focused on how stressed people feel in response to stressors. Lazarus and Folkman (1984) make
it clear that in order for people to experience stress, they must both perceive an event as stressful
and threatening. It is therefore possible that people may interpret stressors as stressful but not
threatening. Thus, the concept of strain in this study was intended to capture peoples
interpretation of stress as threatening using both high agitation (tension) and exhaustion
(depletion). Furthermore, this study was particularly interested in understanding how strain
impacts the sexual experiences that people have. Previous work had indicated that stress was
negatively associated with sexual activity; thus it was of interest to investigate if separating strain
into tension or depletion could possibly shed some light on which aspect --high arousal or
exhaustion-- is more responsible for that effect.
Investigating BDSM Practitioners
The other primary interest in this study was to investigate if people who engage in BDSM
activity, compared to people who do not engage in BDSM activity, respond in meaningfully
different ways to strain. Over the past few decades, researchers have begun to take a more
normative approach to understanding the motivations behind BDSM activity, whereas in the past
engaging in BDSM activity was seen as a result of some pathology; however, the evidence of

73
pathology within the BDSM community has been largely refuted. Unfortunately, there exists
little empirical work investigating the sexual activity within the BDSM community and how it
may be influenced by certain variables, such as stress. For example, Baumeister (1988) proposed
the escape from self theory, a theory mostly relevant to masochists, but there has been little
research attempting to show a link between the desire to escape a burdensome selfhood and
actual BDSM activity. Furthermore, other BDSM researchers have posited that BDSM activity
can act as a stress reliever (Newmahr, 2010; Williams, 2006). This study was therefore aimed at
providing an initial investigation into how strain influences sexual activity within BDSM
practitioners.
Going into the study a large concern was correctly identifying individuals as people who
do or do not engage in BDSM, especially given some of the stigmatization still surrounding
being labeled as kinky. As evidenced by this quote from Wiseman (1996), someone active in
the BDSM community, it may not be very easy to determine whether someone should be
identified as a BDSM practitioner:
The dividing line between SM sex and vanilla sex can sometimes be arbitrary.
Obviously, someone who owns a suitcase full of whips, chains, and restraints, and so
forth is into SM. But what about the woman who can reach orgasm by having her
nipples bitten? What about the two lovers who really get off on tying each other up
with silk scarves? What about the person who loves getting spanked? (p. 13)
It was therefore important to use a combination of methods to identify whether or not
people engaged in BDSM. The first method was designed to capture a behavioral identification
of BDSM activity by simply asking people if they engaged in BDSM activity with their partner
(while referencing a very large, wide-ranging and inclusive list of BDSM activities). The second
method asked individuals to self-identify as a BDSM practitioner. This was likely a higher bar

74
for individuals, as evidenced by the different response rates when compared against the
behavioral identification.2 In order to investigate the effect of strain on sexual activity, a
combination of the behavioral and self-identity methods was used to classify individuals: people
who engaged in BDSM and self-identified as a practitioner (Practitioners), people who engaged
in BDSM activity but did not self-identify (Behaviorists), and people who neither engaged in
BDSM nor self-identified (Non-Practitioners).3 This method allowed for clean comparisons
across groups and also resulted in groups of relative equal numbers. Interestingly, the
demographics of these groups were mostly equivalent as well: similar ages, gender, religion,
education, ethnicity, and length of current relationship.
Strain and Sexual Activity
The most meaningful differences between the groups were related to actual sexual
activity. Consistent with Hypothesis 1a, BDSM status moderated the relationship between
tension and sexual activity. Specifically, Practitioners level of tension was negatively associated
with their sexual behavior, but this was not the case for Behaviorists or Non-Practitioners.
Furthermore, and inconsistent with Hypothesis 1b, BDSM status also moderated the relationship
between depletion and sexual activity. Depletion negatively predicted sexual activity for
Practitioners and somewhat so for Non-Practitioners, but not so for Behaviorists. In regards to
Non-Practitioners, these results suggest that exhaustion may be more responsible for the negative

A Chi-square test showed that people responded differently between the BDSM behavioral question and the self2
identity question, (1, N = 227) = 73.64, p < .001.
3
A Chi-square test showed the frequency of Practitioners, Behaviorists, and Non-Practitioners was different
2
between the MTurk sample and the community/volunteer, (2, N = 227) = 36.69, p < .001 (MTurk sample: 17.1%
Practitioners, 37.3% Behaviorists, 45.6% Non-Practitioners; community/volunteer sample: 55% Practitioners, 29%
Behaviorists, 16% Non-Practitioners).

75
relationship between stress and sexual activity that has been found in previous research
(Bodenmann, Ledermann, & Bradbury, 2007). What is further interesting is that the same pattern
was found for self-identified BDSM practitioners. Depletion may represent a part of the strain
response that makes it particularly difficult for people to engage in any sexual activity, regardless
if it includes BDSM behavior or not; individuals may not feel they have the energy or resources
to engage in intimacy with their partner.
Tension, on the other hand, was not associated with sexual behavior for non selfidentified BDSM practitioners, or Behaviorists. High arousal and irritability may not be as much
of a problem for people who do not consistently engage in BDSM behavior, whereas for those
who do, this could place BDSM practitioners in a particularly dangerous state to be engaging in
activities requiring high levels of attention and focus. This is also consistent with the negative
relationship between depletion and sexual activity for Practitioners. However, these results with
Practitioners are generally inconsistent with past theorizing suggesting that individuals would
want to engage in BDSM activity when feeling stressed (Williams, 2006). Scott (1997) proposed
that there is a higher level of intensity when including BDSM as part of sex activity; however, in
this study Practitioners also reported a reduction in vanilla sex in response to increases in strain.
This suggests that self-identified BDSM practitioners may only be engaging in sexual activity
when they feel they are in the right frame of mind. Contrasted against the results found with
Behaviorists and Non-Practitioners, there may be something unique about identifying oneself as
a BDSM practitioner in the approach taken to sexual intimacy. Additionally, Newmahr (2010)
posited that BDSM may represent a serious leisure activity for individuals, and this is arguably
consistent with Practitioners higher mean levels of sexual activity, sexual desire, and sexual

76
motivations in this study compared to Behaviorists and Non-Practitioners (also consistent with
Cross & Mathesonss [2005] findings). But what this also suggests is that the serious leisure of
sexual BSDM activity, as well as vanilla sex, for Practitioners can be negatively influenced by
strain and potentially interrupted. It is possible that self-identifying also leads to more sex and
BDSM activity in general, but because Practitioners engage in BDSM activities more often, they
are also potentially more cautious in deciding to engage in those activities. Thus, the bar for
engaging in sexual intimacy might be slightly higher in self-identified BDSM practitioners
compared to people who do not self-identify as BDSM practitioners. Future research could focus
on attempting to identify the point at which individuals decide to self-identify as a BDSM
practitioner and if it is all related to the activities they engage in.
Also contrary to expectations, it was evidenced that Practitioners had higher levels of
strain compared to Non-Practitioners and occasionally Behaviorists. Previous research did not
suggest that this would be the case, and in fact, recent literature on the subjective well-being of
BDSM practitioners would have suggested the opposite (Wismeijer & van Assen, 2013). Thus,
future research might investigate the possible reasons for this. For example, one reason might be
related to the potential negative consequences of stigmatization that BDSM practitioners face in
their daily life. Alternatively, it might be something unique to how self-identified BDSM
practitioners are interacting with their surrounding environment. And finally, it might be related
to some third variable not yet identified.
Another interesting finding for Practitioners that was not found for Behaviorists or NonPractitioners was that relationship satisfaction negatively moderated the strain and sexual activity
relationship. Previous research in the general community had found that relationship satisfaction

77
was a moderator of the negative relationship between stress and sexual activity (Bodenmann,
Ledermann, & Bradbury, 2007), but in this study when conceptualizing stress as strain, this
result was not found for everyone. Instead, only Practitioners relationship satisfaction
moderated the relationship between strain and sexual activity. This might be further related to the
other results indicating that strain impacts sexual activity negatively for Practitioners. For these
individuals, strain could be particularly problematic in relationships where individuals are not
feeling satisfied with their partner and when they are deciding to engage in intense sexual BDSM
activity with them. It is possible if Practitioners engagement in sex and BDSM activity is
already strongly influenced negatively by strain, then a lack of feeling satisfied in their
relationship could only serve to further complicate their ability to do so. On the other hand,
relationship satisfaction could serve as a buffer to a BDSM practitioners response to strain and
the potential negative impact on their ability to engage in sex and BDSM.
Strain and Sexual Desire, Sexual Functioning, and Sexual Satisfaction
As mentioned earlier, past research with the general population has found negative
relationships between stress, sexual activity, sexual satisfaction, and sexual functioning
(Bodenmann, Atkins, Schr, & Poffet, 2010; Bodenmann, Ledermann, & Bradbury, 2007). The
three groups responded fairly similarly to these three outcome variables of interest: sexual desire,
sexual functioning, and sexual satisfaction. First, tension and depletion were not associated at all
with sexual desire. It was expected that depletion would be associated with a reduction in sexual
desire for everyone and that tension would be associated with an increase in sexual desire,
especially among practitioners. In particular, if BDSM practitioners are motivated to engage in
BDSM behavior for stress relief (Baumeister, 1988; Williams, 2006), then it seemed plausible

78
that only increases in the arousing part of the strain response, versus exhaustion, would be
related to increased desire. Surprisingly, however, none of the predictions specific to sexual
desire were supported; straintension or depletionwas not related to how much desire for
sexual behavior individuals had. One possible explanation for this might be that the bar for
indicating sexual desire is much lower than actually engaging in sexual behavior, such that
tension and depletion does not as easily impact a persons intention, or want, to engage in sexual
behavior. This may be consistent with the attitude-behavior link that is seen in other domains;
having a desire to engage in a behavior is not the same as actually engaging in it.
Second, it was also hypothesized that there would be a negative relationship between
strain and sexual functioning. Sexual functioning was conceptualized in the ASEX scale by the
ease of becoming and staying aroused and having satisfying orgasms. This hypothesis was
supported in regards to depletion for individuals who engaged in sexual activity: depletion
negatively predicted sexual functioning for all three groups. This result appears consistent with
the negative relationship between depletion and sexual activity for Practitioners and NonPractitioners; increases in depletion are associated with not only reductions in sexual activity but
also difficulty in arousal and orgasm.
Finally, depletion and sexual satisfaction were found to be negatively related for
everyone. Similar to the results with sexual dysfunction, increases in depletion are associated
with reductions in feeling less satisfied with sexual activity. Thus it appears that having low
energy and reduced emotional and cognitive resources can influence the response to sexual
activity.

79
Although depletion was negatively associated with reductions in sexual satisfaction and
sexual functioning for all three groups, Practitioners and Behaviorists, but not Non-Practitioners,
also experienced a reduction in sexual satisfaction and sexual functioning with an increase in
tension, contrary to expectations. In regards to Practitioners, this result appears consistent with
the negative relationship with tension and sexual activity, like the negative relationship between
depletion and sexual activity. Practitioners seem particularly impacted by both depletion and
tension in regards to engaging in sexual activity and being emotionally and physically satisfied
with the activity. Thus, strain has the potential to disrupt not only Practitioners frequency of
sexual activity but also their response to the sexual activity.
For Behaviorists, on the other hand, having higher levels of arousal and agitation also
negatively impacted the satisfaction felt towards the sexual activity they engaged in and how
well they could maintain arousal and have orgasms; however, these results are somewhat
inconsistent with the lack of significant relationships between tension, depletion, and sexual
activity. Thus, strain may only impact Behaviorists response to sexual activity but not the
frequency of engaging in sexual activity. Behaviorists might therefore represent a group who
responds to strain in a way that is somewhere between Non-Practitioners and Practitioners. The
difference between Practitioners and Behaviorists specifically is therefore an avenue for future
research. Again, as mentioned earlier, there might be something unique to people who selfidentify as BDSM practitioners that is different from the mentality of those who occasionally
engage in BDSM during sexual activity.

80
Avoidance Coping
One possible explanation for the effects that was explored in this study was avoidance
coping. It was predicted that there would be no difference in avoidance coping between BDSM
Practitioners and Non-Practitioners. This expectation was not supported in this study, as BDSM
Practitioners indicated that they used more avoidance coping strategies in response to stressful
events than Non-Practitioners. However, the results from the regression analysis indicated that,
for everyone, reported strain positively predicted avoidance coping. As all three groups
experienced increases in tension and depletion, they also endorsed avoidance coping to a greater
degree. Therefore, although BDSM practitioners may say they use avoidance coping strategies
more overall when stressed, it does not appear that BDSM practitioners are any more likely to
use avoidance coping as a strategy in response to strain (as measured by depletion and tension).
These results are somewhat inconsistent with the findings from Cross and Matheson (2006). In
that study, BDSM practitioners did not differ from non-practitioners in a variety of escapist
behaviors, such as recreational drug use, danger seeking, role playing, or day dreaming.
Differences between Tops, Bottoms, and Switches
BDSM role was explored as an additional moderator of the strain and sexual activity
relationship within BDSM practitioners. In general, it was found for Practitioners that an
increase in strain --both tension and depletion-- was associated with a reduction in sexual
activity. However, there were some interesting differences between tops, bottoms, and switches
when sexual activity was separated into sexual BDSM activity and vanilla sex.

81
When tops were depleted, they engaged in less sexual BDSM activity but not less vanilla
sex. This was also partially the case when tops were feeling more tension as well. Thus, tops
engagement in sexual BDSM activity seems to be more impacted by strain compared to their
engagement in vanilla sex. One possible explanation for this might be that tops are in a
particularly responsible role when engaging in sexual BDSM activity with their partner. As the
doer of a combination of sexual and BDSM activities, they must constantly monitor not only
their actions but the responses of their bottom. Thus, when they are feeling both more agitated
and/or exhausted, this could put them at a potentially compromising position of not being able to
fulfill these duties. However, strain does not seem to influence a tops frequency of engaging in
vanilla sex, perhaps because there is less pressure to perform at such a high level compared to
when they engage in sexual BDSM activities. Therefore, when tops are under strain they might
decide not to engage in sexual BDSM activities as frequently, and/or the decision to engage in
sexual BDSM activities is at a higher level for participation than it is with vanilla sex because
those activities could require a greater degree of resources and mental stability. And finally, there
was at least some initial evidence to suggest that tension also might influence tops engagement
of non-sexual BDSM activity as well, although this should be explored in future studies.
Very different results were found with bottoms. When bottoms were experiencing more
strain, both tension and depletion, they engaged in less vanilla sex. Conversely, bottoms sexual
BDSM activity was not impacted by strain. One possible explanation might be that bottoms may
decide not to, or be mentally not able to, engage in vanilla sex as often when under strain
because they might anticipate that something will be missing from vanilla sex. In other words,
when either feeling exhausted or agitated, bottoms may anticipate that they wont be able to get

82
the release that the addition of BDSM activities could facilitate when mixed with vanilla sex, and
thus they do not seek to engage in just vanilla sex alone. One could argue that this does provide
some support for Baumeisters (1988) escape from self theory; it may be that bottoms enjoy an
escape to a lower level of awareness, and paradoxical increase in self-control and self-esteem,
when they engage in BDSM activities during sexual activity. However, Baumeister did specify
masochism (the experience and enjoyment of pain) as the method through which people would
escape the burdensome selfhood, so it would be of interest in future studies to investigate the
exact BDSM activities bottoms are engaging in during sex. This will help determine what BDSM
activities are possibly missing during vanilla sex and thus potentially responsible for this effect.
For example, individuals who self-identify as masochists might be engaging in painful BDSM
activities, whereas bottoms that do not self-identify as masochistic might be engaging in nonpainful activities to achieve the same result (e.g., service, role playing). Baumiester also posited
that masochistic desires should increase following external demands on the self, but desire (for
BDSM and vanilla sex) was not associated with strain in this study. Finally, it is also possible
that strain is not an appropriate proxy for a burdensome selfhood (responsibility and selfesteem). It may be that selfhood is conceptually different than the experience of strain or that
strain does not influence ones sense of self. Self-esteem maintenance might be one avenue of
future investigation. Thus, this study does provide some initial support for the escape from self
theory in regards to bottoms, but additional work is needed.
Unfortunately for switches, they experienced reductions in vanilla sex with increases in
tension and depletion and somewhat reduced sexual BDSM activity with an increase in
depletion. Thus, switches represent a group who experienced the potential negative

83
consequences of strain from both a top and bottom perspective. This is somewhat intuitive, given
switches proclivities to take both the doer and receiver role.
Limitations and Future Research Directions
There are limitations to this study which should be acknowledged. First, an obvious
limitation is that the results in this study only represent correlations between the variables and
not cause and effect. Although it is possible that an increase in strain causes a reduction in sexual
activity, it is equally plausible that reduced sexual activity can also cause an increase in strain
(or, said another way, increased sexual activity can cause a reduction in strain). In other words, it
is very possible that there is a bi-directional relationship between these two variables. It would
therefore be of interest in future research to continue to investigate the causal nature of strain,
and thus temporal effects, on sexual activity. One possible way to further investigate the
relationship between strain and sexual activity is to look at these variables longitudinally, thereby
tracking the relative increases and decreases over time. In this manner it may be determined if
strain precedes reduced sexual activity or if reduced sexual activity precedes strain. For example,
Ein-Dor and Hirschberger (2012) used a daily diary method to collect measures from 75 Israeli
adults for 18 consecutive weekdays and using lagged-day analyses found that the probability of
having sex on a day increased when that day was preceded by a stressful day and that having sex
relieved stress for men and women who reported high relationship satisfaction. The authors posit
that having sex can act as a calming mechanism, interrupting the continued elevation of stress
from one day to the next. However, this study only assessed stress and sexual activity over a
short amount of time and it measured stress in response to stressors, confusing the strain
response. Relative levels of strain and sexual activity will likely fluctuate over longer periods of

84
time. Thus, it is of interest to explore the directionality of the relationship between stress and
sexual activity in a causal manner.
Second, relying on participants self-reports to assess sexual activity may lead to biases
resulting from stereotypes (e.g., distortions resulting from group affiliation) or social desirability.
However, these issues are somewhat addressed in studies investigating different methods of
assessing sexual activity that have shown that they produce similar results (Alexander & Fisher,
2003). Individuals in this study reported their relative level of strain and sexual activity over the
past week, which could possibly have been influenced by retrospective bias as well. In particular,
in longitudinal studies it would be of interest to ensure accurate timing of data collection (e.g.,
internet-based diaries with time stamps).
An additional avenue for future research would be to recruit dyads. By having data from
both members of a dyad the effect of each partners level of strain and subsequent sexual activity
could be investigated (again, ideally longitudinally). Bodenmann, Ledermann, and Bradbury
(2007) found that there were dyadic and reciprocal effects of external stress (e.g., daily hassles)
and internal stress (e.g., relationship arguments) on sexual activity and sexual satisfaction. When
investigating a persons experiences within a romantic relationship, especially sexual activity
with another person, it would be advantageous to understand the experiences of the partner as
well to better place the results in context.
This research explored how strain was associated with sexual activity and how that
relationship was moderated by BDSM status and relationship satisfaction. Another moderator of
this relationship that would be of interest to study is attachment style. Previous work has
demonstrated that attachment style can influence sexual motivations (Davis, Shaver, & Vernon,

85
2004), frequency of sexual activity and sexual dysfunction (Brassard, Shaver & Lussier, 2007),
and sexual satisfaction (Birnbaum, Reis, Mikulincer, Gillath, & Orpaz, 2006). Again, the context
of a romantic relationship, in terms of how individuals approach the relationship and care for
each other, may further influence how people respond to strain and when they engage in sexual
activity.
Finally, because Practitioners were the most negatively impacted by strain, future work
could attempt to further investigate the reasons behind this effect and possible interventions that
would reduce it. For example, a meta-analysis provided some evidence to show that a clinical
program called Mindfulness-Based Stress Reduction (MBSR) can be used to help alleviate issues
resulting from physical, psychosomatic, and psychiatric disorders (Grossman, Niemann,
Schmidt, & Walach, 2004). Thus, mindfulness training might be one way for Practitioners to
effectively deal with an increase in strain and its subsequent effect on sexual activity. The
negative relationship between strain and sexual activity demonstrated by Practitioners seem
particularly informative in light of current lay beliefs and stigmas surrounding BDSM
practitioners. It might be argued from these results that Practitioners are particularly mindful
when engaging in sex, both vanilla sex and BDSM sex. How much of this effect is due to BDSM
practitioners individual response to strain (i.e., I dont feel up to it or Im not going to get
what I want) or influenced by their concern for their partners well-being (i.e., Ill hurt my
partner during sex if Im in this state) is still in need of investigation, however, and could be
better informed by studying dyads.

86
Conclusion
In conclusion, this study makes two contributions to the literature studying stress and
sexual activity. First, the results from this work indicate that tension and depletion can have
different effects on sexual activity and that it is important to separate these conceptualizations of
stress to better understand how people approach and experience sexual intimacy. Depletion, the
low arousal and exhausted component of the strain response, has the potential to negatively
influence not only the frequency of sexual activity but how much people psychologically and
physically enjoy it. This is different than tension, the high arousal and agitated component of the
strain response, which in this study only seemed to negatively influence people who engage in
BDSM activities, and this is therefore the second contribution of this study; strain seems to
influence sexual activity in meaningfully different ways between Practitioners, Behaviorists, and
Non-Practitioners. One of the theoretical motivations for engaging in BDSM activities is for
stress relief; however, this study demonstrated that increases in strain were associated with
reductions in sexual activity for BDSM practitioners, although in different ways for tops,
bottoms, and switches. This is one of the first studies to empirically explore the effect of stress
on practitioners, hopefully shedding some light on a sub-population that has been historically
under-studied.

REFERENCES
Alexander, M.G., & Fisher, T.D. (2003). Truth and consequences: Using the bogus pipeline to
examine sex difference in self-reported sexuality. Journal of Sex Research, 40, 27-35.
Amirkhan, J.H. (1990). A factor analytically derived measure of coping: The coping strategy
indicator. Journal of Personality and Social Psychology, 59 (5), 1066-1074.
Antony, M.M., Bieling, P.J., Cox, B.J., Enns, M.W., & Swinson, R.P. (1998). Psychometric
properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in
clinical groups and a community sample. Psychological Assessment, 10 (2), 176-181.
Aron, A., Aron, E.N., & Smollan, D. (1992). Inclusion of Other in the Self scale and the
structure of interpersonal closeness. Interpersonal Relations and Group Processes, 63
(4), 596-612.
Aron, A., Aron, E.N., Tudor, M., & Nelson, G. (1991). Close relationships as including other in
the self. Journal of Personality and Social Psychology, 60 (2), 241-253.
Baumeister, R.F. (1988). Masochism as Escape from Self. The Journal of Sex Research, 25 (1),
28-59.
Birnbaum, G.E., Reis, H.T., Mikulincer, M., Gillath, O., & Orpaz, A. (2006). When sex is more
than just sex: Attachment orientations, sexual experience, and relationship quality.
Journal of Personality and Social Psychology, 91 (5), 929- 943.
Bodenmann, G., Atkins, D.C., Schr, M., & Poffet, V. (2010). The association between daily
stress and sexual activity. Journal of Family Psychology, 24 (3), 271-279.
Bodenmann, G., Ledermann, T., Blattner-Bolliger, D., & Galluzzo, C. (2006). The association
between everyday stress, critical life events, and sexual dysfunction. Journal of Nervous
and Mental Disease, 194, 494-501.
Bodenmann, G., Ledermann, T., & Bradbury, T.N. (2007). Stress, sex, and satisfaction in
marriage. Personal Relationships, 14, 551-569.
Brame, G.G., Brame, W.D., & Jacobs, J. (1993). Different Loving: The World of Sexual
Dominance and Submission. New York: Villard Books.

88
Brassard, A., Shaver, P.L., & Lussier, Y. (2007). Attachment, sexual experience, and sexual
pressure in romantic relationships: A dyadic approach. Personal Relationships, 14, 475493.
Connolly, P.H. (2006). Psychological functioning of bondage/domination/sado-masochism
(BDSM) practitioners. Journal of Psychology & Human Sexuality, 18, 79-120.
Cross, P.A., & Matheson, K. (2006). Understanding sadomasochism: An empirical examination
of four perspectives. Journal of Homosexuality, 50 (2/3), 133-166.
Davis, D., Shaver, P.R., Vernon, M.L. (2004). Attachment style and subjective motivations for
sex. Personality and Social Psychology Bulletin, 30 (8), 1076- 1090.
Desmond, D.D., Shevlin, M., & MacLachlan, M. (2006). Dimensional analysis of the coping
strategy indicator in a sample of elderly veterans with acquired limb amputations.
Personality and Individual Differences, 40, 249-259.
Ein-Dor, T. & Hirschberger, G. (2012). Sexual healing: Daily diary evidence that sex relieves
stress for men and women in satisfying relationships. Journal of Social and Personal
Relationships, 29 (1), 126-139.
Greenberg, J.S. (1987). Stress and Sexuality. New York: AMS Press, Inc.
Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress
reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research, 57,
35-43.
Hanly, M.A.F. (Ed.). (1995). Essential Papers on Masochism. New York: New York University
Press.
Hendrick, S. (1998). A generic measure of relationship satisfaction. Journal of Marriage and
Family, 50 (1), 93-98.
Hendrick, S., & Hendrick, C. (2002). Linking romantic love with sex: Development of the
Perceptions of Love and Sex Scale. Journal of Social and Personal Relationships, 19 (3),
361-378.
Hill, C.A., & Preston, L.K. (1996). Individual differences in the experience of sexual motivation:
Theory and measurement of dispositional sexual motives. The Journal of Sex Research,
33 (1), 27-45.
Hobfoll, S.E. (1989). Conservation of resources: A new attempt at conceptualizing stress.
American Psychologist, 44 (3), 513-524.

89
Hurlbert, D.F., Apt, C., Hurlbert, M.K., & Pierce, A.P. (2000). Sexual compatibility and the
sexual desire-motivation relation in females with hypoactive sexual desire disorder.
Behavior Modifcation, 24 (3), 325-347.
Lazarus, R.S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
Lovibond, P.F., & Lovibond, S.H. (1993). Manual for the Depression Anxiety Stress Scales
(DASS). Psychology Foundation Monograph. (Available from The Psychology
Foundation, Room 1005 Mathews Building, University of New South Wales, NSW 2052,
Australia).
Lovibond, P.F., & Lovibond, S.H. (1995). The structure of negative emotional states:
Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression
and Anxiety Inventories. Behavior Research Therapy, 33 (3), 335-343.
McCarthy, B. (2003). Marital sex as it ought to be. Journal of Family Psychotherapy, 14 (2), 112.
McGahuey, C.A., Gelenberg, A.J., Laukes, C.A., Moreno, F.A., Delgado, P.L., McKnight,
K.M., & Manber, R. (2000). The Arizona Sexual Experiences Scale (ASEX): Reliability
and validity. Journal of Sex and Marital Therapy, 26, 25-40.
Metz, M.E., & Epstein, N. (2002). Assessing the role of relationship conflict in sexual
dysfunction. Journal of Sex and Marital Therapy, 28, 139-164.
Morokoff, P.J., & Gillilland, R. (1993). Stress, sexual functioning, and marital satisfaction. The
Journal of Sex Research, 30 (1), 43-53.
Moser, C., & Kleinplatz, P.J. (2006). Introduction. Journal of Homosexuality, 50 (2/3), 1-15.
Moser, C., & Kleinplatz, P.J. (2007). Themes of SM Expression. In Langdridge, D. & Barker, M.
(Eds.), Safe, Sane, and Consensual: Contemporary Perspectives on Sadomasochism (pp.
35-54). New York: Palgrave Macmillan.
Newmahr, S. (2010). Rethinking kink: Sadomasochism as serious leisure. Qualitative Sociology,
33, 313-331.
Randall, A.K., & Bodenmann, G. (2009). The role of stress on close relationships and marital
satisfaction. Clinical Psychology Review, 29, 105-115.
Revenson, T.A., & DeLongis, A. (2011). Couples Coping with Chronic Illness. In S. Folkman
(Ed.), The Oxford Handbook of Stress, Health, and Coping (pp. 86-100). New York:
Oxford University Press.

90
Sandnabba, N.K., Santilla, P., & Nordling, N. (1999). Sexual behavior and social adaptation
among sadomasochistically- oriented males. The Journal of Sex Research, 36 (3), 273282.
Scarry, E. (1985). The Body in Pain: The Making and Unmaking of the World. New York:
Oxford University Press.
Scott, G.G. (1997). Erotic Power: An Exploration of Dominance and Submission. Secaucus, NJ:
Carol Publishing Group.
Shirom, A. (1989). Burnout in work organizations. In C. L. Cooper & I. Robertson (Eds.)
Handbook of Occupational Health Psychology (pp. 25-48). Chichester, U.K.: Wiley.
Shirom, A. (2003). Job-related burnout: A review. In J.C. Quick & L.E. Tetrick (Eds.),
Handbook of Occupational Health Psychology (pp. 245-264). Washington, D.C:
American Psychological Association.
Shirom, A., & Melamed, S. (2006). A comparison of the construct validity of two burnout
measures in two groups of professionals. International Journal of Stress Management, 13
(2), 176-200.
Taylor, S.E. (2011). Affiliation and Stress. In S. Folkman (Ed.), The Oxford Handbook of Stress,
Health, and Coping (pp. 86-100). New York: Oxford University Press.
Weinberg, T.S. (1987). Sadomasochism in the United States: A review of recent sociological
literature. The Journal of Sex Research, 23 (1), 50-69.
Weinberg, T.S., & Kamel, G.W.L. (Eds.). (1983). S and M: Studies in Sadomasochism. New
York: Prometheus Books.
Weinberg, T.S., Williams, C.J., & Moser, C. (1984). The social constitutes of sadomasochism.
Social Problems, 31 (4), 379-389.
Williams, D.J. (2006). Different (painful!) strokes for different folks: A general overview of
sexual sadomasochism (SM) and its diversity. Sexual Addiction and Compulsivity, 13,
333-346.
Wiseman, J. (1996). SM 101: A Realistic Introduction. San Francisco, CA: Greenery Press.
Wismeijer, A. & van Assen, M. (2013). Psychological characteristics of BDSM practitioners.
Journal of Sex Medicine, 10, 1943-1952.

APPENDICES

APPENDIX A
DEMOGRAPHICS AND RELATIONSHIP CHARACTERISTICS (FIRST PART)

93
In order to take this study, you must be at least 18 years old. Are you at least 18 years old?
Yes (proceed to survey)
No (taken to end debriefing)
1) Gender (circle one):
Female Male Not listed (please fill in: __________________)
2) Sexual orientation: Gay/Lesbian Bisexual Heterosexual Not listed (__________)
3) Age: ________ (in years)
4) Ethnicity: Asian-American
African American
Caucasian
Hispanic/Latino
Middle Eastern
Bi-racial
Not listed (please fill in:_______________)
5) Please indicate the highest level of education you have achieved: __________________
6) Please indicate your religion: ______________________(or N/A if none)
7) How long have you been in a relationship with your current romantic partner (in months)?
8) What is your relationship status with your current partner?
Casual/Short-term
Serious long-term
Engaged
Married
In a civil union
In a domestic partnership
9) Do you and your partner currently have an open relationship (allowed to have sexual activity
with other people or engage in other types of erotic activity with other people)? Yes
No
If no, has your relationship with your partner ever been open? Yes
No
10) Do you currently live with your partner?
Yes
No
If yes, for how long have you lived with your partner (in months)? ____________
11) Do you have any children?
Yes
No
If yes, how many children do you have? _________________
If yes, how many of your children did you have with your current romantic partner? ____
Please consider the following:
*The following behaviors are typically thought of as sexual activities. These
activities may be used for a variety of different reasons. Please indicate if you have
engaged in any of these activities, although you may not have engaged in all these
activities.
Sexual Activity: sexual touching or rubbing, sexual kissing, manual sex, oral sex,
masturbation in front of other, using sex toys with other, vaginal intercourse, and anal
intercourse, etc.
*The following behaviors are typically considered BDSM activities (Bondage/DisciplineDominance/Submission- Sadism/Masochism).Many people fantasize or engage in the
following behaviors, however many people may not refer to these behaviors using the
terminology BDSM. These activities may also be used for a variety of different reasons.
Please indicate if you have engaged in any of these behaviors, regardless of what you call
them or why you do them, even if you have not engaged in all of these activities.
BDSM Activity: food-play, scratching or biting, spanking, flogging, paddling, caning,
whipping, bondage, restriction, fetish clothing, cross dressing, role-play or age-play,
humiliation, electrical and temperature play, sensory deprivation, cutting/piercing, breath
play, knife play, chastity devices, fisting, nipple or other genital clamps, etc.
10) Have you ever engaged in sexual activities with your partner? Yes
No
If no, have you ever engaged in sexual activities in the past? Yes
No
If no, have you ever desired to engage in sexual activities? Yes
No
11) Have you ever engaged in BDSM activities with your partner? Yes
No
If yes, please respond to the following questions:

94
a) During BDSM activities, do you typically prefer to receive sensations or give
sensations to your partner?
1
I almost always
prefer to receive
sensations

2
I usually prefer
to receive
sensations

3
I equally prefer
receiving and
giving sensations

4
I usually prefer
to give
sensations

5
I almost always
prefer to give
sensations

b) During BDSM activities, do you typically prefer to be controlled by your partner or


be in control of your partner?
1
I almost always
prefer to be
controlled

2
I usually prefer
to be controlled

3
I equally prefer
being controlled
and being in
control

4
I usually prefer
to be in control

5
I almost always
prefer to be in
control

c) During BDSM activities, how much do you like your partner making you feel pain?
1
I dislike it
greatly

2
I somewhat
dislike it

3
I neither enjoy it
nor dislike it

4
I somewhat like
it

5
I like it very
much

d) During BDSM activities, how much do you like making your partner feel pain?
1
I dislike it
greatly

2
I somewhat
dislike it

3
I neither enjoy it
nor dislike it

4
I somewhat like
it

5
I like it very
much

If no, have you engaged in BDSM activities in the past? Yes


No
If yes, please respond to the following:
a) During BDSM activities, do you typically prefer (or did prefer) to receive
sensations or give sensations to your partner?
1
I almost always
prefer to receive
sensations

2
I usually prefer
to receive
sensations

3
I equally prefer
receiving and
giving sensations

4
I usually prefer
to give
sensations

5
I almost always
prefer to give
sensations

95
b) During BDSM activities, do you typically prefer (or did prefer) to be
controlled by your partner or be in control of your partner?
1
I almost always
prefer to be
controlled

2
I usually prefer
to be controlled

3
I equally prefer
being controlled
and being in
control

4
I usually prefer
to be in control

5
I almost always
prefer to be in
control

c) During BDSM activities, how much do you like (or did like) your partner
making you feel pain?
1
I dislike it
greatly

2
I somewhat
dislike it

3
I neither enjoy it
nor dislike it

4
I somewhat like
it

5
I like it very
much

d) During BDSM activities, how much do you like (or did like) making your
partner feel pain?
1
I dislike it
greatly

2
I somewhat
dislike it

3
I neither enjoy it
nor dislike it

4
I somewhat like
it

5
I like it very
much

If no, have you ever desired, or been interested, in BDSM activities? Yes No
If yes, please respond to the following:
a) During BDSM activities, would you prefer to receive sensations or give
sensations to your partner?
1
I would almost
always prefer to
receive
sensations

2
I would usually
prefer to receive
sensations

3
I would equally
prefer receiving
and giving
sensations

4
I would usually
prefer to give
sensations

5
I would almost
always prefer to
give sensations

b) During BDSM activities, would you prefer to be controlled by your partner or


be in control of your partner?
1
I would almost
always prefer to
be controlled

2
I would usually
prefer to be
controlled

3
I would equally
prefer being
controlled and
being in control

4
I would usually
prefer to be in
control

5
I would almost
always prefer to
be in control

96
c) During BDSM activities, how much would you like your partner making you
feel pain?
1
I would dislike it
greatly

2
I would
somewhat dislike
it

3
I would neither
enjoy it nor
dislike it

4
I would
somewhat like it

5
I would like it
very much

d) During BDSM activities, how much do you like making your partner feel
pain?
1
I would dislike it
greatly

2
I would
somewhat dislike
it

3
I would neither
enjoy it nor
dislike it

4
I would
somewhat like it

5
I would like it
very much

APPENDIX B
STRESS SUBSCALE OF THE DASS STRESS SCALE (ANTONY, BIELING, COX, ENNS, &
SWINSON, 1998; LOVIBOND & LOVIBOND, 1993, 1995)

98

For each of the statements, please choose the number which best indicates how much the
statement applied to you OVER THE LAST WEEK.
(0= Did not apply to me at all, 1= applied to me to some degree, or some of the time, 2= applied
to me a considerable degree, or a good part of the time, 3= applied to me very much, or most of
the time)
1. I found myself getting upset by quite trivial things.
2. I found myself getting upset rather easily.
3. I found that I was very irritable.
4. I found myself getting agitated.
5. I felt I was rather touchy.
6. I was intolerant of anything that kept me from getting on with what I was doing.
7. I tended to over-react to situations.
8. I found myself getting impatient when delayed in any way.
9. I found it difficult to relax.
10. I found it hard to calm down after something upset me.
11. I found it difficult to tolerate interruptions to what I was doing.
12. I felt that I was using a lot of nervous energy.
13. I found it hard to wind down.
14. I was in a state of nervous tension.

APPENDIX C
SHIROM-MELAMED BURNOUT MEASURE (SHIROM & MELAMED, 2006)

100

Please indicate how often, OVER THE LAST WEEK, you have felt each of the following feelings.
(1= never or almost never, 2= very infrequently, 3= quite infrequently, 4= sometimes, 5= quite
frequently, 6= very frequently, 7= always or almost always)
P= Physical fatigue, E= Emotional exhaustion, C= Cognitive weariness.
1. I feel tired. (P)
2. I have no energy for going to work in the morning. (P)
3. I feel physically drained. (P)
4. I feel fed up. (P)
5. I feel like my batteries are dead. (P)
6. I feel burned out. (P)
7. My thinking process is slow. (C)
8. I have difficulty concentrating. (C)
9. I feel like Im not thinking clearly. (C)
10. I feel like Im not focused in my thinking. (C)
11. I have difficulty thinking about complex things. (C)
12. I feel I am unable to be sensitive to the needs of those around me. (E)
13. I feel I am not capable of investing emotionally in those around me. (E)
14. I feel I am not capable of being sympathetic to those around me. (E)

APPENDIX D
AVOIDANCE SUBSCALE OF THE COPING STRATEGY INDICATOR (AMIRKHAN,
1990; DESMOND, SHEVLIN, & MACLACHLAN, 2006)

102
For the following items, think about a stressful event that occurred IN THE LAST WEEK and
consider the manner in which you coped with the event using the following scale (0= not at all,
1= a little, 2= a lot).
1. Tried to distract yourself from the problem.
2. Did all you could to keep others from seeing how bad things really were.
3. Daydreamed about better times.
4. Spent more time alone than usual.
5. Watched television more than usual.
6. Avoided being with people in general.
7. Buried yourself in a hobby or sports activity to avoid the problem.
8. Slept more than usual.
9. Fantasized about how things could have been different.
10. Identified with characters in movies or novels.
11. Wished that people would just leave you alone.

APPENDIX E
PHYSICAL, SEXUAL ACTIVITY AND BDSM ACTIVITY

104
In this section of questions you will be asked to describe the activities you may or may not
have engaged in during the last week.
Category 1: Affection with Another Person
The following behaviors would be considered affectionate: holding hands, hugging, affectionate
kissing, tickling, cuddling, play wrestling, gentle physical contact (rubbing, scratching), and
massage, etc. For the purpose of this category, these behaviors should be considered as nonsexual; however, they may have occurred before and/or after sexual activity.
1) Please rate the frequency of affectionate behaviors you have engaged in OVER THE
LAST WEEK (0= never during the last week, 1= 1 time, 2= 2 times, 3= 3 times, 4= 4
times, 5= 5 times, 6= 6 times, 7= 7 or more times)
2) Over how many days total did you engage in affectionate behavior? (0=0 days, 1=1 day,
2= 2 days, 3= 3 days, 4= 4 days, 5= 5 days, 6= 6 days, 7= 7 days/daily)
3) Please rate the degree of initiation between you and your partner (-3= my partner
initiated all the activities, -2= my partner initiated most of the activities, -1= my partner
initiated somewhat more of the activities, 0= my partner and I initiated an equal number
of the activities 1= I initiated somewhat more of the activities, 2= I initiated most of the
activities, 3= I initiated all of the activities)
4) Please rate how satisfied you were with the affectionate behavior (0= not at all satisfied,
2= somewhat satisfied, 4= extremely satisfied)
5) Please describe the affectionate behavior(s) you engaged in over the last
week:___________
6) Of the number of times you engaged in affectionate behavior over the last week, did any
of them not include your primary partner? Yes or no?
7) Please rate how much you desired to engage in affectionate behavior OVER THE LAST
WEEK, regardless of whether or not you actually engaged in affectionate behavior (0=
did not desire at all, 2= somewhat desired, 4= very much desired)
Category 2: Sexual Activity with Self (Initiation not relevant for this question)
The following behaviors would be considered sex with self: masturbation, manual sex with self,
using sex toys for ones self, etc. For the purpose of this category, these behaviors should have
only been performed alone, not in the presence of another person.
1) Please rate the frequency of times you engaged in sex with yourself OVER THE LAST
WEEK (0= never during the last week, 1= 1 time, 2= 2 times, 3= 3 times, 4= 4 times, 5=
5 times, 6= 6 times, 7= 7 or more times)
2) Over how many days total did you engage in sex with yourself? (0=0 days, 1=1 day, 2= 2
days, 3= 3 days, 4= 4 days, 5= 5 days, 6= 6 days, 7= 7 days/daily)
3) Please rate how satisfied you were with the sex with yourself (0= not at all satisfied, 2=
somewhat satisfied, 4= extremely satisfied)
4) Please describe the sexual activities you engaged with yourself in over the last week:
__________

105
5) Please rate how much you desired to engage in sex with yourself OVER THE LAST
WEEK, regardless of whether or not you actually engaged in sex with yourself (0= did
not desire at all, 2= somewhat desired, 4= very much desired)
Category 3: Sexual Activity with Another Person
The following behaviors would be considered sex with other: sexual touching or rubbing, sexual
kissing, manual sex with other, oral sex, masturbation in front of other, using sex toys with other,
vaginal intercourse, and anal intercourse, etc.
1) Please rate the frequency of sexual activities you engaged in OVER THE LAST WEEK
(0= never during the last week, 1= 1 time, 2= 2 times, 3= 3 times, 4= 4 times, 5= 5 times,
6= 6 times, 7= 7 or more times)
2) Over how many days total did you engage in sexual activities? (0=0 days, 1=1 day, 2= 2
days, 3= 3 days, 4= 4 days, 5= 5 days, 6= 6 days, 7= 7 days/daily)
3) Please rate the degree of initiation between you and your partner (-3= my partner
initiated all the activities, -2= my partner initiated most of the activities, -1= my partner
initiated somewhat more of the activities, 0= my partner and I initiated an equal number
of the activities, 1= I initiated somewhat more of the activities, 2= I initiated most of the
activities, 3= I initiated all of the activities)
4) Please rate how satisfied you were with the sex with your partner (0= not at all satisfied,
2= somewhat satisfied, 4= extremely satisfied)
5) Please describe the sexual activities you engaged in with your partner over the last week:
______
6) Of the number of times you engaged in sexual activities over the last week, did any of
them not include your primary partner? Yes or no?
7) Please rate how much you desired to engage in sexual activities OVER THE LAST
WEEK, regardless of whether or not you actually engaged in sexual activity (0= did not
desire at all, 2= somewhat desired, 4= very much desired)
Category 4: BDSM Activity with Self that is Non-Sexual (Initiation not relevant here)
The following would be considered non- sexual BDSM self activity if it occurred outside of a
sexual context or did not include any masturbation, manual sex with self, or use sex toys for
ones self: food-play, scratching or biting, spanking, flogging, paddling, caning, whipping,
bondage, restriction, fetish clothing, cross dressing, role-play or age-play, humiliation, electrical
and temperature play, sensory deprivation, cutting/piercing, breath play, knife play, chastity
devices, fisting, nipple or other genital clamps, etc. (e.g. flogging ones self or self-bondage).
1) Please rate the frequency of times you engaged in non-sexual BDSM activity with
yourself OVER THE LAST WEEK (0= never during the last week, 1= 1 time, 2= 2
times, 3= 3 times, 4= 4 times, 5= 5 times, 6= 6 times, 7= 7 or more times)
2) Over how many days total did you engage in non-sexual BDSM activity with yourself?
(0=0 days, 1=1 day, 2= 2 days, 3= 3 days, 4= 4 days, 5= 5 days, 6= 6 days, 7= 7
days/daily)

106
3) Please rate how satisfied you were with the non-sexual BDSM activity with yourself (0=
not at all satisfied, 2= somewhat satisfied, 4= extremely satisfied)
4) Please describe the non-sexual BDSM activities you engaged in with yourself over the
last week with yourself: __________________
5) Please rate how much you desired to engage in non-sexual BDSM activity with yourself
OVER THE LAST WEEK, regardless of whether or not you actually engaged in nonsexual BDSM activity with yourself (0= did not desire at all, 2= somewhat desired, 4=
very much desired)
Category 5: BDSM Activity with Self that is Sexual (Initiation not relevant here)
The following would be considered sexual BDSM self activity if it occurred during a sexual
context and/or included any masturbation, manual sex with self, or the use sex toys for ones
self: food-play, scratching or biting, spanking, flogging, paddling, caning, whipping, bondage,
restriction, fetish clothing, cross dressing, role-play or age-play, humiliation, electrical and
temperature play, sensory deprivation, cutting/piercing, breath play, knife play, chastity devices,
fisting, nipple or other genital clamps, etc. (e.g. self bondage with masturbation).
1) Please rate the frequency of times you engaged in sexual BDSM activity with yourself
OVER THE LAST WEEK (0= never during the last week, 1= 1 time, 2= 2 times, 3= 3
times, 4= 4 times, 5= 5 times, 6= 6 times, 7= 7 or more times)
2) Over how many days total did you engage in sexual BDSM activity with yourself? (0=0
days, 1=1 day, 2= 2 days, 3= 3 days, 4= 4 days, 5= 5 days, 6= 6 days, 7= 7 days/daily)
3) Please rate how satisfied you were with the sexual BDSM activity with yourself (0= not
at all satisfied, 2= somewhat satisfied, 4= extremely satisfied)
4) Please describe the sexual BDSM activities you engaged in with yourself over the last
week: __________________
5) Please rate how much you desired to engage in sexual BDSM activity with yourself
OVER THE LAST WEEK, regardless of whether or not you actually engaged in sexual
BDSM activity with yourself (0= did not desire at all, 2= somewhat desired, 4= very
much desired)
Category 6: BDSM Non-Sexual activity with Another Person
The following behaviors would be considered BDSM: food-play, scratching or biting, spanking,
flogging, paddling, caning, whipping, bondage, restriction, fetish clothing, cross dressing, roleplay or age-play, humiliation, electrical and temperature play, sensory deprivation,
cutting/piercing, breath play, knife play, chastity devices, fisting, nipple or other genital clamps,
etc. For the purpose of this category, these activities should only be considered if they happened
without any sexual activity; however, they may have occurred before and/or after sexual
activity.
1) Please rate the frequency of non-sexual BDSM activities you engaged in with another
person OVER THE LAST WEEK (0= never during the last week, 1= 1 time, 2= 2 times,
3= 3 times, 4= 4 times, 5= 5 times, 6= 6 times, 7= 7 or more times)

107
2) Over how many days total did you engage in non-sexual BDSM activity with another
person? (0=0 days, 1=1 day, 2= 2 days, 3= 3 days, 4= 4 days, 5= 5 days, 6= 6 days, 7= 7
days/daily)
3) Please rate the degree of initiation between you and your partner (-3= my partner
initiated all the activities, -2= my partner initiated most of the activities, -1= my partner
initiated somewhat more of the activities, 0= my partner and I initiated an equal number
of the activities, 1= I initiated somewhat more of the activities, 2= I initiated most of the
activities, 3= I initiated all of the activities)
4) Please rate how satisfied you were with the non-sexual BDSM activity you engaged in
with your partner (0= not at all satisfied, 2= somewhat satisfied, 4= extremely satisfied)
5) Please describe the non-sexual BDSM activities you engaged in with your partner over
the last week: __________________
6) Of the number of times you engaged in non-sexual BDSM activities over the last week,
did any of them not include your primary partner? Yes or no?
7) Please rate how much you desired to engage in non-sexual BDSM activities with another
person OVER THE LAST WEEK, regardless of whether or not you actually engaged in
non-sexual BDSM activity with another person (0= did not desire at all, 2= somewhat
desired, 4= very much desired)
Category 7: BDSM Sexual activity with Another Person
The following behaviors would be considered BDSM: food-play, scratching or biting, spanking,
flogging, paddling, caning, whipping, bondage, restriction, fetish clothing, cross dressing, roleplay or age-play, humiliation, electrical and temperature play, sensory deprivation,
cutting/piercing, breath play, knife play, chastity devices, fisting, nipple or other genital clamps,
etc. Please consider this category as when any of the previous mentioned activities are
happening within a sexual context, or when any sexual activity (sexual touching or rubbing,
sexual kissing, manual sex with other, oral sex, masturbation in front of other, using sex toys
with other, vaginal intercourse, and anal intercourse, etc.) is happening during any BDSM
activity (e.g. bondage during vaginal penetration).
1) Please rate the frequency of sexual BDSM activities that you engaged in with another
person OVER THE LAST WEEK (0= never during the last week, 1= 1 time, 2= 2 times,
3= 3 times, 4= 4 times, 5= 5 times, 6= 6 times, 7= 7 or more times)
2) Over how many days total did you engage in sexual BDSM activity with another person?
(0=0 days, 1=1 day, 2= 2 days, 3= 3 days, 4= 4 days, 5= 5 days, 6= 6 days, 7= 7
days/daily)
3) Please rate the degree of initiation between you and your partner (-3= my partner
initiated all the activities, -2= my partner initiated most of the activities, -1= my partner
initiated somewhat more of the activities, 0= my partner and I initiated an equal number
of the activities, 1= I initiated somewhat more of the activities, 2= I initiated most of the
activities, 3= I initiated all of the activities)

108
4) Please rate how satisfied you were with the sexual BDSM activity with your partner (0=
not at all satisfied, 2= somewhat satisfied, 4= extremely satisfied)
5) Please describe the sexual BDSM activities you engaged in with your partner over the
last week: __________________
6) Of the number of times you engaged in sexual BDSM activities over the last week, did
any of them not include your primary partner? Yes or no?
7) Please rate how much you desired to engage in sexual BDSM activities with another
person OVER THE LAST WEEK, regardless of whether or not you actually engaged in
sexual BDSM activity with another person (0= did not desire at all, 2= somewhat
desired, 4= very much desired)

APPENDIX F
ARIZONA SEXUAL EXPERIENCES SCALE (MCGAHUEY, GELENBERG, LAUKES,
MORENO, DELGADO, MCKNIGHT, & MANBER, 2000)

110
Did you engaged in any sexual activity during the last week? If yes, please respond to the
following scale:
For each item, please indicate your OVERALL level DURING THE LAST WEEK, including
TODAY.
1. How strong was your sex drive? (1= no sex drive, 2= very weak, 3= somewhat weak, 4=
somewhat strong, 5= very strong, 6= extremely strong)
2. How easily were you sexually aroused (turned on)? (1= never aroused, 2= very difficult,
3= somewhat difficult, 4= somewhat easily, 5= very easily, 6= extremely easily)
3. (Male/Female) How easily could you get and keep an erection?/ How easily did your
vagina become moist or wet during sex? (1= never, 2= very difficult, 3= somewhat
difficult, 4= somewhat easily, 5= very easily, 6= extremely easily)
4. How easily could you reach an orgasm? (1= never reach an orgasm, 2= very difficult, 3=
somewhat difficult, 4= somewhat easily, 5= very easily, 6= extremely easily)
5. Were your orgasms satisfying? 1= cant reach an orgasm, 2= very unsatisfying, 3=
somewhat unsatisfying, 4= somewhat unsatisfying, 5= very satisfying, 6= extremely
satisfying

APPENDIX G
AMORE (AFFECTIVE AND MOTIVATIONAL OREINTATION RELATED TO EROTIC
AROUSAL QUESTIONNAIRE) (HILL & PRESTON, 1996)

112
Please indicate how true or descriptive each statement is of you using the following scale:
(1= Not at all true, 3= Moderately true, 5= Completely true)
1. When bad or frustrating things happen to me, many times I feel like engaging in sexual
fantasy or doing something sexual to try to get to feel better. (Relief from Stress)
2. Sexual activities and fantasies are most stimulating when my partner seems extremely
self-assured and demanding during sex. (Experiencing the Power of Ones Partner)
3. I find that I often feel a sense of superiority and power when I am expressing myself
sexually. (Enhancement of Power)
4. One of the most exciting and aspects of sex is the sense of power I feel in controlling the
sexual pleasure and stimulation my partner experiences. (Enhancement of Power)
5. I find sexual behavior and sexual fantasy most exciting when I can feel forceful and
dominant with my partner. (Enhancement of Power)
6. Thinking about sex or engaging in sex sometimes seems to help me keep on going when
things get rough. (Relief from Stress)
7. It is frequently very arousing when my partner gets forceful and aggressive during sex.
(Experiencing the Power of Ones Partner)
8. Often engaging in sex with my partner makes me feel like I have established myself as a
force to be reckoned with. (Enhancement of Power)
9. Sex and sexual fantasies are most exciting when I feel like my partner has totally
overpowered me and has taken complete control. (Experiencing the Power of Ones
Partner)
10. When I am going through difficult times, I can start feeling better by simply engaging in
some type of sexual fantasy or behavior. (Relief from Stress)
11. Many times it is extremely thrilling when my partner takes complete charge and begins to
tell me what to do during sex. (Experiencing the Power of Ones Partner)
12. Often I have a real need to feel dominated and possessed by my partner while we are
engaged in sex or sexual fantasy. (Experiencing the Power of Ones Partner)
13. I find that thinking about or engaging in sexual activity can frequently get me through
unpleasant times in my life. (Relief from Stress)
14. I often feel like fantasizing about sex or expressing myself sexually when life isnt going
very well and I want to feel better about myself. (Relief from Stress)
15. Engaging in sexual activity is a very important way for me to experience and appreciate
the personal strength and forcefulness that my partner is capable of. (Experiencing the
Power of Ones Partner)
16. Thinking about sex or engaging in sexual behavior can frequently be a source of relief
from stress and pressure for me. (Relief from Stress)
17. Doing something sexual often seems to greatly improve my outlook on life when nothing
seems to be going right. (Relief from Stress)
18. Many times when I am feeling unhappy or depressed, thinking about sex or engaging in
sexual activity will make me feel better. (Relief from Stress)
19. When things are not going well, thinking about sex or doing something sexual is often
very uplifting for me and helps me to forget about my problems for a while. (Relief from
Stress)

113
20. Engaging in sexual activity is very important to me as a means of feeling powerful and
charismatic. (Enhancement of Power)
21. I often have a strong need to fantasize about sex or to do something sexual when I feel
upset or unhappy. (Relief from Stress)
22. I really enjoy having sex as a way of exerting dominance and control over my partner.
(Enhancement of Power)
23. I often find it a real turn-on when my partner takes charge and becomes authoritative
during sexual activity or fantasy. (Experiencing the Power of Ones Partner)
24. I am often very excited by the sense of power that I feel I have over my partner when I
am sexually attractive to him or her. (Enhancement of Power)
25. I find it very exciting when my partner becomes very demanding and urgent during sex
and sexual fantasy, as if he or she needs to possess me completely. (Experiencing the
Power of Ones Partner)
26. I frequently become very aroused when I sense that my partner is excited by controlling
and directing our sexual activity or fantasy. (Experiencing the Power of Ones Partner)
27. Expressing myself sexually generally makes me feel personally strong and in control of
things. (Enhancement of Power)
28. I am especially excited by the feeling of domination and being controlled by my partner
during sex and sexual fantasy. (Experiencing the Power of Ones Partner)
29. Often the sense of power that I have over my sexual partner can be extremely
exhilarating. (Enhancement of Power)
30. I frequently find it quite arousing to be very directive and controlling while having sex
with my partner. (Enhancement of Power)

APPENDIX H
THE RELATIONSHIP ASSESSMENT SCALE (HENDRICK, 1998)

115
Please choose a number for each item which best answers that item for you in regards to your
current romantic relationship.
1. How well does your partner meet your needs? (1 = Poorly, 3 = Average, 5 = Extremely well)
2. In general, how satisfied are you with your relationship? (1 = Unsatisfied, 3 = Average, 5 =
Extremely satisfied)
3. How good is your relationship compared to most? (1 = Poor, 3 = Average, 5 = Excellent)
4. How often do you wish you hadn't gotten into this relationship? (5 = Never, 3 = Average, 1
=Very often)
5. To what extent has your relationship met your original expectations? (1 = Hardly at all, 3 =
Average, 5 = Completely)
6. How much do you love your partner? (1 = Not much, 3 = Average, 5 = Very much)
7. How many problems are there in your relationship? (5 = Very few, 3 = Average, 1 =Very
many)

APPENDIX I
INCLUSION OF OTHER IN SELF SCALE (ARON, ARON, & SMOLLAN, 1992)

117
Please choose the set of circles below which best describes your relationship with your partner.

Self

Partner

Self

Self

Partner

Partner

Self

Self

Partner

Partner

Self

Self

Partner

Partner

APPENDIX J
DEMOGRAPHICS AND RELATIONSHIP CHARACTERISTICS (SECOND PART)

119
Do you identify as someone who engages in BDSM activity? Yes

No (continue to debriefing)

If yes, please respond to the following questions:


How important is engaging in additional erotic behavior to your current relationship?
1
2
3
4
5
Not at all
Somewhat
Very
important
important
important
If you consider yourself to have a BDSM relationship with your current partner, please
describe this relationship. _________________________
What BDSM role(s) do you take on in your current relationship? ____________
Have you had a BDSM relationship in the past? Yes

No

If yes, what BDSM role(s) did you take on? ___________________


If yes, please describe this relationship. ______________________
What BDSM activities do you normally engage in? ___________________

APPENDIX K
RECRUITMENT INFORMATION (POSTED ON MTURK AND FETLIFE)

121
This study is entitled, Stress and Sexual Activity and is being conducted by Ellen Lee,
a graduate student at Northern Illinois University. The purpose of this study is to examine how
stress affects physical and sexual activity. In order to participate, you must have a relationship
partner and be at least 18 years old. This study will ask questions about your stress level and the
physical and sexual activities you have engaged in over the last week, as well as relationship
characteristics and other demographics. Participation is completely anonymous. If you would
like to participate, please follow this link: xxx

APPENDIX L
INFORMED CONSENT INFORMATION

123
Stress and Sexual Activity
I agree to participate in the research project titled Stress and Sexual Activity being conducted
by Ellen Lee, a graduate student at Northern Illinois University. I have been informed that the
purpose of the study is to examine the relationship between stress and sexual activity.
I understand that if I agree to participate in this study, I will be asked to fill out a series of
questionnaires regarding the following: my stress level, physical and sexual activities I have
engaged in with my partner over the last week, and characteristics of my relationship with my
partner and other demographics.
I am aware that my participation is voluntary and may be withdrawn at any time without penalty
or prejudice. (For Mturk users only: I realize that I will be paid $1.00 for participating in this
study and understand that I may withdraw at any time without loss of that credit or any other
penalties). If I have any additional questions concerning this study, I may contact Ellen Lee at
EllenMorganLee@gmail.com. In addition, if I have any questions regarding my rights as a
research participant, I may contact the Northern Illinois University Office of Research
Compliance at (815) 753-8588.
I understand that the intended benefits of this study include providing insight into how stress can
affect sexual activity.
I have been informed that there are no foreseeable risks or discomforts I could potentially
experience while participating in this experiment. I have read what I am expected to do in this
study and after reviewing the process I find no foreseeable risks to myself. I understand that all
information gathered during this experiment will be completely anonymous.
I understand that my consent to participate in this project does not constitute a waiver of any
legal rights or redress I may have as a result of my participation. By pressing Continue I
acknowledge that I have read this informed consent form and wish to participate in this study.

APPENDIX M
DEBRIEFING INFORMATION

125
Dear Participant:
Thank you for participating in this study.
The purpose of this experiment is to investigate how stress impacts the physical and sexual
activities people engage in with their partner. We hypothesize that stress can affect these
activities differently, depending on a variety of relationship and personality characteristics, such
as relationship satisfaction and attachment.
If you are interested in this topic we recommend that you read the following:
Bodenmann, G., Atkins, D.C., Schr, M., & Poffet, V. (2010). The association between daily stress
and sexual activity. Journal of Family Psychology, 24 (3), 271-279.
Bodenmann, G., Ledermann, T., & Bradbury, T.N. (2007). Stress, sex, and satisfaction in
marriage. Personal Relationships, 14, 551-569.
Davis, D., Shaver, P.R., Widaman, K.F., Vernon, M.L., Follette, W.C., & Beitz, K. (2006). I cant
get no satisfaction: Insecure attachment, inhibited sexual communication, and sexual
dissatisfaction. Personal Relationships, 13, 465- 483.

If you have experienced any amount of psychological discomfort as a consequence of


participating in this study, please visit the American Psychological Associations Help Center
(apa.org/helpcenter) to find a licensed mental health counselor near you. You can also call a 24hour Crisis Line at 1-866-4CRISIS (427-4747) to speak to someone immediately.
Once again, thank you for your participation. If you have any questions regarding this study or
would like a summary of the results, please contact Ellen Lee at EllenMorganLee@gmail.com.

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