Higher sexual excitation is associated with an increase in sex-linked substance use in women with a history of unwanted sexual contact

Authors

Harper R. Jones, University of Nebraska-LincolnFollow
Tierney K. Lorenz, University of Nebraska-LincolnFollow

ORCID IDs

Harper R. Jones https://orcid.org/0000-0002-9930-4527

Tierney K. Lorenz https://orcid.org/0000-0002-4999-1584

Date of this Version

2023

Document Type

Article

Citation

Published in The Canadian Journal of Human Sexuality 31:3 (2022), pp. 432–442.

doi:10.3138/cjhs.2022-0020

Comments

Copyright © 2022 Sex Information and Education Council of Canada; published by University of Toronto Press. Used by permission.

Abstract

Survivors of unwanted sexual contact have an increased likelihood of using substances in sexual situations, which puts them at heightened risk for intoxication-related harms. Separately, research has indicated that women may intentionally use substances in sexual situations to either enhance pleasure (i.e., increase sexual excitation) and/or reduce sexual anxiety or shame (i.e., reduce sexual inhibition), a phenomenon termed sex-linked substance use (SLSU). A predominant assumption in the literature is that women with unwanted sex histories are more likely to disengage during sex, suggesting greater inhibition-related SLSU; however, there is little prior research directly examining if women who have unwanted sex histories primarily engage in SLSU to increase sexual excitation or decrease inhibitions. We conducted exploratory analyses of an online survey in a convenience sample of 516 undergraduate women including data on their history of unwanted sex, SLSU, and sexual excitation/inhibition. Sexual excitation mediated the association between a history of unwanted sexual contact and SLSU, suggesting that women with unwanted sexual histories reported higher levels of sexual excitation, which in turn was associated with a higher likelihood of using substances to increase pleasure during sexual activity. Specifically, arousability, partner characteristics, and power dynamics subfactors were significant mediators. Sexual inhibition did not mediate the relationship between a history of unwanted sexual contact and SLSU, suggesting that women with unwanted sex histories may have been less likely to use substances to reduce sexual inhibitions. If replicated, these findings suggest that sexual excitation may be a useful target of intervention surrounding SLSU, particularly in women with histories of unwanted sexual contact. Specifically, treatments targeting cognitive and affective tendencies associated with sexual excitation may help women who engage in SLSU to have safe, pleasurable sexual activity, without increasing the risk of intoxication-related harms.