The Relationship Between COVID-19 Confinement, Psychological Adjustment, and Sexual Functioning, in a Sample of Portuguese Men and Women

Background: Past research has revealed the detrimental effects of social isolation and physical distancing measures in health related outcomes. However, only recently COVID-19 confinement measures provided a context to test whether such detrimental effects exist in the human sexuality domain. Aim: This study was aimed at testing the relationship between COVID-19 confinement levels and sexual functioning domains in men and women, while accounting for the mediating role of psychological adjustment during lockdown. Methods: Two hundred and forty five men and 417 women completed a web survey on the effects of COVID-19 in sexual health. The reference period includes the first confinement in Portugal (March 19-June 1, 2020). Data were handled under Hays' procedures for simple mediation analysis. Outcomes: Measurement outcomes included self-reported levels of confinement, IIEF and FSFI scores, and psychological adjustment during lockdown. Results: Psychological adjustment during lockdown mediated the relationship between confinement levels and most sexual functioning domains in men but not in women. Also, while confinement levels were not directly related with most sexual functioning domains, psychological adjustment during lockdown did predict lower sexual functioning in both genders. Clinical Translation: Findings support that human sexual functioning should be framed within a contextual perspective, emphasizing how psychological adjustment and situational life stressors, such as lockdown situations, shape individuals' sexuality. Such perspective should be considered in treatment protocols implemented during current pandemic. Strengths & Limitations: Data add to the literature on the effects of lockdown in the sexuality domain. However, the study precludes inference of causality and targets only a little proportion of all the dynamics involved in sexuality during the current historical moment. Conclusion: Psychological adjustment during COVID-19 seems to have a role on human sexual functioning, over the single effects of confinement. Copyright (C) 2021, International Society of Sexual Medicine. Published by Elsevier Inc. All rights reserved.