Exploring the Associations of Personality and Sexual Health Using the DSM-5 Alternative Model for Personality Disorders

This study explored the relationships between sexual health indicators (i.e., sexual satisfaction, distress, and function) and the DSM-5 Alternative Model for Personality Disorders, a promising dimensional framework for assessing personality pathology. A sample of 489 participants seeking help in private practice clinics completed self-report measures of sexual satisfaction, distress, and function, as well as dyadic adjustment, psychological distress, romantic attachment, personality impairment, and pathological personality facets. Results first showed that participants reaching the cutoffs for a personality disorder had significantly higher sexual distress and lower sexual function compared to participants without a personality disorder. Second, path analyses controlling for psychological distress, dyadic adjustment, and romantic attachment revealed that, for women, the Criterion B Intimacy Avoidance facet was consistently linked with higher sexual distress and lower sexual satisfaction and function. For men, result patterns were more complex, linking Criterion B Separation Insecurity with high sexual distress, and Separation Insecurity and Intimacy Avoidance facets with low sexual function. In addition, Criterion B Irresponsibility, Rigid Perfectionism, as well as Criterion A Intimacy impairment were linked with higher sexual satisfaction. These findings improve our understanding of the links between personality and sexual health and provide support for considering personality difficulties in sexual health interventions.