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Masters Theses & Specialist Projects Graduate School

Summer 2020

The Association Between Body Image, Sexual Satisfaction, and

Relationship Satisfaction in Adults
Hannah Krisher
Western Kentucky University, [email protected]

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Satisfaction in Adults" (2020). Masters Theses & Specialist Projects. Paper 3229.
https://digitalcommons.wku.edu/theses/3229

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THE ASSOCIATION BETWEEN BODY IMAGE, SEXUAL SATISFACTION, AND
RELATIONSHIP SATISFACTION IN ADULTS

A Thesis
Presented to
The Faculty of the Department of Psychology
Western Kentucky University
Bowling Green, Kentucky

In Partial Fulfillment
Of the Requirements for the Degree
Masters of Arts

By
Hannah Krisher

August 2020
 THE ASSOCIATION BETWEEN BODY IMAGE, SEXUAL SATISFACTION, AND
RELATIONSHIP SATISFACTION IN ADULTS

Date Recommended____________________

____________________________________
Frederick Grieve, Director of Thesis

____________________________________
Timothy Thornberry

____________________________________
Christopher G. Chandler

8/13/20
___________________________________
Associate Provost for Research and Graduate Education
 ACKNOWLEDGMENTS

My thesis would still just be an intimidating idea without Dr. Rick Grieve’s

belief in me as a student and researcher. Thank you for your unwavering support and

encouragement of me for almost three years now. I am most appreciative of your

patience and time investment, as this process has required a lot of both. Your patience

showed me that you were confident in my abilities to complete this project, despite any

personal setbacks I brought to the table. The time you invested in this project is a

testament to your invaluable role as a professor and thesis director. I will always

appreciate that Dr. Grieve chaired my thesis project.

I would also like to thank my thesis committee members, Dr. Tim Thornberry and

Dr. Chris Chandler. Thank you, Dr. Thornberry, for happily agreeing to be on this

committee. You provided materials that aided in my research process, responded

promptly to any communications, and challenged me as a critical thinker. Thank you, Dr.

Chandler, for sharing your personal experiences as a past WKU Clinical Psychology

student to help encourage me to finally make large strides of progress on my thesis. You

showed me firsthand how this process is possible and rewarding. I appreciate both of you

for your patience, promptness, and commitment to this project.

Another person who deserves ample gratitude is Leigh Ann Mathis, who was my

internship supervisor. Leigh Ann, thank you for allowing me to learn from you and for

trusting me to help make a difference in clients’ lives. Thank you for checking in on me

even after our internship experience was over, and for reminding me that I can

accomplish difficult tasks.

iii
 Next, I want to thank my peer, Riley Cotterman, for sharing her knowledge of

Qualtrics, MTurk, and data cleaning with me. You spent several hours helping me

upload my study online and sat with me while I anxiously collected the data, which were

both things that reaped you little benefit. Thank you, Riley, for your help, but more so

for your friendship. I also want to thank my classmate and friend, Hannah Turner, for her

confidence in me and her cheerful, uplifting demeanor that overpowered my doubts and

pessimistic thoughts. You are a wonderful role model, friend, and supporter.

I am forever thankful to my family for their excitement for me and support of me

as I approach the next phase in my life. Thank you to my parents who firmly pushed me

to set thesis goals that would benefit my future, while also gracefully accepting the

emotions that accompanied this process. Next, I want to thank my sisters who shared

words of encouragement and confidence with me on a weekly basis. To my entire

family: you all remind me that we can do anything!

Lastly, I want to thank Landon for his commitment to me over the course of

graduate school, and especially during thesis completion. Landon, thank you so much for

reminding me why my work is important when I lose sight of the end goal. Thank you

for being patient with me and for loving me despite seeing the worst sides of me.

Whether I needed to talk, needed to be alone to work, or needed a mental break, we

figured it out together. I will always remember and appreciate our office workdays, our

thesis chats at dinner, and our small celebrations of victory along the way. I love you and

thank you!

iv
 TABLE OF CONTENTS

Introduction……………………………………………………………………………….1

Body Image Concerns….……………………………....………………………….2

Divorce……...………….……………………………………………………........4

Self-Esteem…….………………………………………………………………….4

Relationship Theories………………………………………………………...…...4

Body Image Defined................................................................................................7

Media Influences……………………………………………………….….7

Social Pressures…………………………………………………………...8

Dating Status and Body Image……………………………………….….10

Body Mass Index (BMI) ………………………………………………...11

Sexual Satisfaction……………………………………………………………….12

Sexual Functioning………………………………………………………12

Body Image and Sexual Satisfaction…………………………………….13

Self-Expansion…………………………………………………………...13

Relationship Satisfaction………………………………………………………...15

BMI and Relationship Satisfaction………………………………………15

Self-Esteem and Relationship Satisfaction………………………………16

Physical Affection Types………………………………………………...17

Social Support Preferences………………………………………………18

Sexual Satisfaction and Relationship Satisfaction……………………….19

Perceived Valuation……………………………………………………...21

Limitations of Existing Research………………………………………………...24

v
 Present Study…………………………………………………………………….25

Methods…………………………………………………………………………………..27

Participants……………………………………………………………………….27

Design……………………………………………………………………………28

Measures…………………………………………………………………………29

Procedures………………………………………………………………………..30

Results……………………………………………………………………………………32

Discussion………………………………………………………………………………..35

References………………………………………………………………………………..41

Appendix A: Demographics Questionnaire……………………………………………...48

Appendix B: Body Assessment Scale……………………………………………………50

Appendix C: Index of Sexual Satisfaction……………………………………………….51

Appendix D: Relationship Assessment Scale……………………………………………52

Appendix E: Implied Consent Document………………………………………………..53

Appendix F: Debriefing Statement………………………………………………………55

vi
 LIST OF TABLES

Table 1: Participant Demographic Characteristics………………………………………28

Table 2: BAS, ISS, and RAS Descriptive Statistics……………………………………..32

Table 3: Relationship Satisfaction, Body Assessment, and Sexual Concern Correlations

and Descriptive Statistics………………………………………………………………………33

Table 4: Relationship Satisfaction Predicted by Body Image Satisfaction and Sexual

Satisfaction……………………………………………………………………………….34

vii
 THE ASSOCIATION BETWEEN BODY IMAGE, SEXUAL SATISFACTION, AND
RELATIONSHIP SATISFACTION IN ADULTS

Hannah Krisher August 2020 55 Pages

Directed by: Frederick Grieve, Timothy Thornberry, and Christopher Chandler

Department of Psychology Western Kentucky University

The purpose of this thesis was to determine whether body image and sexual

satisfaction predict romantic relationship satisfaction. The 198 participants completed

measures assessing for the predictor and outcome variables. They completed the Body

Assessment Scale (BAS; Lorenzen et al., 2004), Index of Sexual Satisfaction (ISS;

Hudson, 1998; Hudson et al., 1981), and the Relationship Assessment Scale (RAS;

Hendrick, 1988) via a Qualtrics questionnaire. Participants accessed the study online

through Amazon’s Mechanical Turk (MTurk) database and completion took

approximately 10 to 20 minutes. Results suggested that body image and sexual

satisfaction significantly and positively predicted relationship satisfaction. The findings

from this study can be used to inform healthcare professionals about the etiology,

prevention, and treatment of mental health concerns regarding body image, self-esteem,

sexual satisfaction, and interpersonal relationships in adults.

viii
 Chapter I

Introduction

Experiencing concern with one’s body image is not a recent issue. During the last

50 years, body image dissatisfaction has worsened, and has been most commonly studied

in samples of adult women (Muth & Cash, 1997). Various social pressures in the form of

media, advertising, and a growing number of diet programs have negatively impacted

women’s appraisals of their bodies (Hoyt & Kogan, 2001; Muth & Cash, 1997; van den

Brink et al., 2018). Because these social pressures can lead to negative body image

appraisals, there is also the possibility that eating disorders will develop as individuals

attempt to gain a sense of control over the issue. Not only has the media’s depiction of

ideal thinness negatively impacted women, the more recently popular depiction of the

ideal muscular male body has negatively impacted samples of men as well (Lorenzen et

al., 2004). The issue of body image dissatisfaction has long been studied in women, but

now that there is evidence to suggest that men equally experience discontent after

viewing images of muscular men in the media, there is even more reason to further study

the topic in hopes of reducing the risk of mental health concerns, such as the development

of eating disorders and body dysmorphia (Lorenzen et al., 2004).

Along with the concerning information regarding body image dissatisfaction is

the issue pertaining to high national divorce rates and romantic relationship dissolution.

Divorce and lack of exposure to parental intimacy can pose psychological risks, such as

increased depressive symptoms and reduced relationship satisfaction, for both children of

divorce and divorcees themselves (Chun et al., 2016). There is past evidence to suggest

that body image is associated with relationship satisfaction (Hoyt & Kogan, 2001), and

1
that sexual satisfaction plays a role in this relationship (Meltzer & McNulty, 2010; van

den Brink et al., 2018). With this previous knowledge, the relevant issues pertaining to

body image, sexual satisfaction, and relationship satisfaction will be discussed.

Relevant Issues

Body Image Concerns

The first issue relevant to the context of this literature review pertains to body

image dissatisfaction. In their sample of 309 adolescents, Prabhu and D’Cunha (2018)

found that a majority of males and females between ages 14 and 19 were dissatisfied with

their body image. There were no gender differences in the level of dissatisfaction

present, with 49% of females and 51% of males reporting body image dissatisfaction.

However, the desire to be thinner was more common in females than in males. Further,

the majority of male participants who reported body image dissatisfaction indicated that

they desired a larger, stronger physique (Prabhu & D’Cunha, 2018). Additional findings

suggested that a negative body image appraisal is associated with increased mental health

problems, such as low self-esteem, increased risk of eating disorder symptoms such as

restrictive dieting, and increased stress (Prabhu & D’Cunha, 2018). These mental health

concerns are variables that can also influence one’s relationship satisfaction (Sciangula &

Morry, 2009). The researchers argued that it is necessary for healthcare professionals to

be knowledgeable in this area to help reduce the harmful effects that negative body image

can have on one’s mental health (Prabhu & D’Cunha, 2018).

The participants recruited in Prabhu and D’Cunha’s (2018) research consisted of a

sample of adolescents in the Dakshina Kannada district in India, showing how far the

issue of body image dissatisfaction spreads. Using a more westernized sample of

2
participants, Grieve et al. (2006) recruited a sample of 284 college students, and found

that, similar to the adolescent sample, an alarming percentage of participants (45%

females, 38% men) were dissatisfied with their body image, and numerous participants

reported that they engaged in unhealthy weight loss behaviors, such as skipping meals

and using food substitutes. Again, this group of researchers found no gender differences

between how satisfied females and males were with their body image (Grieve et al.,

2006), which contrasts somewhat to previous findings that suggest that women are more

likely than men to be dissatisfied with their body images (Hoyt & Kogan, 2001).

Because researchers are concerned about the development of eating disorders and

other mental health concerns, it is important to understand how body image

dissatisfaction can escalate from a level of normative discontent to a potentially life-

threatening diagnosis. Many researchers believe that perfectionistic personality traits

play a predictive role in the development of eating disorders, and that perfectionism is a

multifaceted concept, with one facet being socially prescribed perfectionism (SPP;

Hewitt & Flett, 1991). SPP occurs when an individual believes that his or her social

environment is expecting him or her to conform to unattainable standards, often

involving his or her physical appearance (Hewitt & Flett, 1991). According to Dawson

and Thornberry’s (2018) model of anorexic symptom development, they argued that SPP

is one variable that leads to the development of harmful eating practices. In addition to

SPP, individuals can also experience thin ideal internalization (TII) as a result of adopting

the socially prescribed ideals of thinness and engaging in behaviors, such as excessive

dieting or exercising, to obtain the ideal body (Dawson & Thornberry, 2018). Once an

individual experiences SPP and TII, and these two factors are paired together with body

3
dissatisfaction (BD), they are more likely to develop symptoms of an eating disorder than

those who are satisfied with their body image and those who have a realistic

understanding of social standards (Dawson & Thornberry, 2018).

Divorce Rates

Another relevant issue is divorce. Generational changes in the variables

associated with divorce motivate researchers to conduct further studies regarding

additional reasons why romantic relationships dissolve, aside from variables such as

religious affiliation, income, and geographical location (Mullins et al., 2012).

Some researchers have analyzed hypotheses suggesting that one’s body mass

index (BMI) is related to his or her marital status and the country’s national divorce rate

(Schneider & Grimps, 2013). They found that married individuals between ages 40 and

64 were heavier than those who were single or never married. Schneider and Grimps

(2013) predicted that, when the national divorce rate is high and there is a higher risk of

relationship dissolution, individuals will be more likely to exhibit a lower BMI than when

divorce rate is lower, which highlights the importance of physical attractiveness as a

global criterion for entering the dating world. The results were somewhat consistent with

predictions, with the relationship between body weight and marriage length depending on

divorce trends of specific countries. Researchers suggested that further information

should be obtained regarding body image and divorce dynamics to help reduce the risk of

increased relationship dissolution (Schneider & Grimps, 2013).

Self-Esteem and Relationship Theories

In addition to the issues of body image concern and high national divorce rates,

another troubling statistic is that overweight women are less likely to be involved in a

4
romantic relationship than women within the normal or underweight range, usually as a

result of lower self-esteem (Lorenzo et al., 2018). Being a member of a healthy romantic

relationship was found to increase feelings of security and reduce feelings of anxiety

(Davila et al., 2017). Following this logic, individuals who struggle with low self-esteem,

such as the overweight women in Lorenzo et al.’s (2018) study, could psychologically

benefit from a healthy romantic relationship. Scholars claim that BMI and bodily

appraisals are important components of an individual’s overall self-esteem (Sciangula &

Morry, 2009), and if professionals can intervene in ways to promote a healthy BMI, body

positivity, and self-esteem, individuals may be more likely to be confident in developing

and maintaining a romantic relationship (Sciangula & Morry, 2009).

If an individual is confident enough in him or herself to pursue a romantic

relationship, he or she will often utilize strategies to minimize the possibility of a

negative experience. One commonly utilized strategy is known as the interdependence

theory, which suggests that relationship quality is internally calculated by analyzing the

costs and benefits of the relationship. A quality relationship is characterized by a low

cost to reward ratio, with the rewards exceeding one’s subjective expectations of the

relationship (Thibaut & Kelley, 1959; van den Brink et al., 2018). Often times, if

individuals struggle with body image concerns or low self-esteem, and they believe that

the costs (i.e., risk of rejection) will overpower the rewards of the relationship, they will

not pursue the relationship (Sciangula & Morry, 2009).

A similar approach that individuals employ when attempting to engage in a

relationship is the risk regulation model. The risk regulation model claims that

individuals with higher levels of global self-esteem are more likely than those with lower

5
levels of global self-esteem to engage in risky behaviors (i.e., vulnerable self-disclosure,

sexual intimacy) necessary to maintain the relationship (Murray et al., 2006). The model

suggests that fear of rejection and lower self-esteem can hinder interpersonal relationship

satisfaction, while higher self-esteem can promote relationship development. Individuals

who are more confident that their partners will continue to accept them and commit to

them are more likely than others with low confidence to experience relationship

satisfaction (Melzer & McNulty, 2010). Because individuals often times unknowingly

incorporate the interdependence theory and risk regulation model into their decision-

making process, it is important that they understand that their body image appraisal

affects their self-esteem (Prabhu & D’Cunha, 2018), and that high self-esteem can

prevent feelings of rejection, and promote the development of relationships (Sciangula &

Morry, 2009).

Once individuals have sufficient self-esteem to engage in a fulfilling relationship,

however, there are still issues pertaining to body image, a component of global self-

esteem (Prabhu & D’Cunha, 2018), and relationship satisfaction (Friedman & Dixon,

1999). Researchers suggested that there is a positive association between marital

problems and body image dissatisfaction, indicating that an increase in marital problems

is related to an increase in body image concerns (Friedman & Dixon, 1999). Sciangula

and Morry (2009) researched a similar topic but analyzed the variables in the opposite

direction. They found that individuals with lower self-esteem experience more

relationship dissatisfaction (Sciangula & Morry, 2009), and suggested that the constructs

of self-esteem and perceived regard predict relationship satisfaction. This research

highlights the issue that one’s marital satisfaction can impact his or her own body image

6
appraisal (Friedman & Dixon, 1999) and that one’s self-esteem can impact his or her

relationship satisfaction (Sciangula & Morry, 2009), which are topics that mental health

professionals can address with their clients. The fact that these two studies show that a

complex relationship between the variables exists, and cannot determine directionality,

shows the need for future research in the area.

Body Image

One’s body image encompasses both psychological and physiological

components, including one’s attitude toward his or her body, the body shape and size,

and individual, internal appraisals (i.e., my hips are too wide) regarding one’s physical

body parts (Cash & Pruzinsky, 2002). As evidenced by the multifaceted definition, body

image is a complex topic, and it is necessary to consider an individual’s personal weight

concern, physical condition, and perceived sexual attractiveness when assessing for body

image concerns (Pujols et al., 2010).

Media and Body Image

There are numerous variables that negatively impact several components of one’s

body image. One of the most commonly studied variables associated with negative body

image is the portrayal of impractical female and male physiques in the media (Green &

Pritchard, 2003). Green and Pritchard (2003) conducted a study in which 139 adult

participants, ranging in age from 19 to 69, completed measures that assessed for various

predictors of body image dissatisfaction. They found that media influence significantly

predicted body image dissatisfaction in their sample of females, but not in their sample of

males. These results contrast findings from Lorenzen et al. (2004) and Robl and Mulgrew

(2016), who found that males’ body satisfaction is also negatively influenced by viewing

7
idealized images in the media. These discrepant findings could be a result of the different

measures used to analyze media influence on participants’ body image. For instance, in

Green and Pritchard’s (2003) study, they collected self-report data on media influence

using a 10-item questionnaire, whereas both Robl and Mulgrew (2016) and Lorenzen et

al. (2004) exposed their participants to idealized images in the media and then collected

self-report data regarding body image.

Robl and Mulgrew (2016) recruited 103 male participants and randomly assigned

them to three conditions in which participants viewed short music video clips containing

various images. The control group viewed clips of scenery, and the realistic group

viewed clips that consisted of both highly attractive and muscular men, as well as a

mixture of scenery and images of averagely attractive men. Lastly, the concentrated

group viewed only clips of highly attractive and muscular men. Robl and Mulgrew

(2016) found that the men in both the realistic and concentrated condition experienced

higher levels of body dissatisfaction than those in the control condition, showing that just

the simple viewing of idealized images in the media can also influence male body image.

Social Pressures and Body Image

Additionally, researchers concluded that both women and men’s body

dissatisfaction is predicted by age, self-esteem, and family pressures (Green & Pritchard,

2003). It was noted that family pressure, in the form of weight-related comments, was

the variable that influenced body image concern the most in both genders. Negative

family pressure, especially from a significant other, can increase the likelihood of older

adults developing a negative self-esteem and body image dissatisfaction (Green &

Pritchard, 2003).

8
 Fortunately, other researchers (Sheets & Ajmere, 2004) claimed that weight-

related comments (i.e., being told to lose or gain weight) were not associated with one’s

self-evaluations in their sample of 554 college-age participants. These discrepant findings

could possibly be attributed to a difference in the age of participants, since Green and

Pritchard’s (2003) participants had a mean age of 42 years old, and Sheets and Ajmere’s

(2004) study had a mean age of 19 years old. In this context of weight-related comments,

perhaps younger individuals are more immune to familial pressures than older

individuals. These findings provide hope that if healthcare professionals can work with

individuals and couples before body image concerns are detrimental, individuals can

receive the necessary resources they need to combat the effects of negative weight-related

comments in adulthood (Sheets & Ajmere, 2004).

Researchers are not only concerned with negative weight-related comments, but

also analyze the implications of cat-calling, whistling, and sexual gestures on women’s

body image. Meltzer and McNulty (2014) indicated that past research has heavily

documented the significant link between this sexualized communication from strangers

and women’s self-esteem, anxiety levels, and body image appraisals (see Frederickson &

Roberts, 1997). When women believe that they are only valued for their physical body,

they often times believe that others strictly view them as sexual objects, rather than

worthy human beings (Meltzer & McNulty, 2014). When this viewpoint is adopted, it is

known as objectification. Furthermore, self-objectification occurs when an individual

repeatedly monitors his or her body and develops a persistent awareness of his or her

physical appearance (van den Brink et al., 2018). The practice of objectification and self-

objectification has posed risks for females in the past, and could possibly generalize to

9
males, given the increased reports of body image dissatisfaction also prevalent in male

samples (van den Brink et al., 2018). Self-objectification heightens the possibility of

developing disordered eating practices, body image dissatisfaction, and other negative

outcomes (Meltzer & McNulty, 2014). It is important to understand the impacts of

objectification to reduce the likelihood that individuals experience body image concerns

as a result.

Dating Status and Body Image

One variable that does not harm an individual’s bodily appraisal is his or her

dating status. Hoyt and Kogan (2001) conducted research in which 288 college students

participated in a study measuring body satisfaction and relationship satisfaction.

Additional information was collected from the participants, including height, weight, and

dating status. Results showed that, overall, women were more dissatisfied with their

bodies than men, and that men were more dissatisfied with their relationships and sex life

than women (Hoyt & Kogan, 2001). Furthermore, results suggested that one’s dating

status (i.e., single, dating, married) did not influence satisfaction with his or her body

image. These findings provide positive information for this field of study, showing that

single, dating, and married individuals are equally pleased and unpleased with their body

image, and that simply being in a relationship does not increase or decrease one’s body

image (Hoyt & Kogan, 2001).

Hoyt and Kogan (2001) continued their study by suggesting that, although college

students’ dating status did not influence their body image, their satisfaction with their

current relationship and sex life influenced body image. There was a significant

relationship between sexual satisfaction and body image, suggesting that individuals who

10
experience more sexual satisfaction also report higher body image confidence.

Additionally, there was a significant association between one’s current dating satisfaction

and his or her body image, suggesting that college-age individuals who were more

unhappy with their current relationship were more dissatisfied with their body image

(Hoyt & Kogan, 2001). This is similar to earlier findings provided by Friedman and

Dixon (1999), who also claimed that marital status was not a significant predictor of body

image concerns. These researchers further found that, in their sample of 16,357 adult

participants, there was a significant relationship between marital satisfaction and body

image satisfaction. The results provided in these two similar studies conducted on

different age groups suggests that relationship satisfaction has an important, established

association with body image satisfaction for people of many ages (Friedman & Dixon,

1999; Hoyt & Kogan, 2001).

Body Mass Index and Body Image

In addition to the results already provided by Hoyt and Kogan (2001), their post

hoc analyses revealed an interesting finding regarding the relationship between one’s

BMI and body image satisfaction. They originally predicted that obese and overweight

individuals would be more dissatisfied with their body image than normal or underweight

individuals. Findings supported portions of the hypothesis. First, they found that

underweight participants were not more satisfied with their body image than those who

were normal or overweight. Furthermore, it was found that individuals who were

classified as obese were the most dissatisfied with their body image, followed by

overweight and underweight participants (Hoyt & Kogan, 2001). These findings suggest

that, although some individuals have an underweight BMI, they still experience body

11
image dissatisfaction comparable to those who are overweight. These results affirm that

body image is a personal appraisal of oneself, often times independent of one’s actual

weight. This personal appraisal, if negative, can lead to a host of dangerous mental

health concerns (Hoyt & Kogan, 2001).

Sexual Satisfaction

Within the context of a romantic relationship, sexual satisfaction is an important

component of a long-lasting, committed, and loving relationship between intimate

partners (Sprecher, 2002). Just like other variables of interest, there are numerous factors

that can affect one’s sexual satisfaction.

Sexual Functioning and Sexual Satisfaction

Most practically, Pujols et al. (2010) found that sexual functioning is significantly

related to sexual satisfaction. Fundamentally, the higher the sexual functioning (i.e., ease

of orgasm, low pain), the higher the sexual satisfaction. This group of researchers

collected data from a sample of 154 adult women, who were between 18 and 49 years of

age, regarding their sexual satisfaction, body image, and sexual functioning, and provided

insightful results. Multiple regression analyses revealed that, even when sexual

functioning is held constant, women who experienced more body image confidence and

fewer body-related distracted thoughts during sex experienced higher sexual satisfaction

than women who experienced frequent distracting thoughts and struggled with their body

image (Pujols et al., 2010). Similar findings were noted in a sample of 166 adult men.

Researchers found that, in their sample of participants ranging from 19 to 75 years old,

decreased sexual functioning resulted in reduced frequency of sexual intercourse, as well

as decreased sexual satisfaction (Stephenson et al., 2018).

12
Body Image and Sexual Satisfaction

Similar to the findings mentioned above regarding body image confidence as a

predictor of sexual satisfaction, van den Brink et al. (2018) concluded that, according to

the risk regulation model, body image concerns can influence one’s propensity to engage

in behaviors that enhance relationship satisfaction, such as sexual intercourse. They posit

that body image dissatisfaction can distract individuals from focusing on the intimate

moment itself, and, rather, focus on their negative body-related appraisals, which reduces

their sexual satisfaction. van den Brink et al. (2018) reached these conclusions by

analyzing self-report measures of body image, sexual satisfaction, perceived relationship

quality, and relationship duration from 151 Dutch adult couples engaged in a

heterosexual relationship for at least six months.

Self-Expansion and Sexual Satisfaction

Self-expansion theory postulates that individuals are intrinsically driven to engage

in novel tasks and activities with the purpose of expanding their skill set and worldly

perspectives (Muise et al., 2019). Individuals engage in self-expansion in many settings,

including within the context of romantic relationships. Muise et al. (2019) argued that, if

people engage in self-expanding activities, they appear increasingly interesting and

desirable to their partners. The researchers designed a study in which they determined

that engaging in self-expanding activities enhances one’s sexual satisfaction and overall

relationship satisfaction.

The study was a 21-day experience study involving 122 couples, between the ages

of 19 and 67, who had been together for at least two years. Participants were e-mailed a

survey each day for 21 days, and were instructed to complete the survey before bedtime.

13
Muise et al. (2019) instructed participants to fill out daily surveys measuring their self-

expansion, sexual desire, and relationship satisfaction. Participants also answered a

single item asking if they had engaged in sexual intercourse that day. If participants

reported that they engaged in sexual intercourse on a certain day, they also completed a

brief measure assessing their sexual satisfaction for that day. After utilizing a multilevel

modeling technique, researchers concluded that higher levels of self-expansion were

associated with higher levels of sexual desire in both members of the relationship (Muise

et al., 2019). The higher the sexual desire of the couple, the more likely it was that they

engaged in sexual intercourse that day. When couples experienced higher sexual desire

as a result of self-expansion, they also experienced higher relationship satisfaction,

showing that sexual desire is a critical, mediating component in the relationship between

self-expansion and relationship satisfaction (Muise et al., 2019). The researchers were

able to determine directionality in this study by conducting a lagged day analyses, in

which they found that self-expansion one day predicted sexual desire and relationship

satisfaction for the next day. The opposite relationship was not significant, meaning that

relationship satisfaction one day did not predict self-expansion the next day (Muise et al.,

2019).

In an additional study conducted by Muise et al. (2019) within the same

publication, it was found that, after three months, self-expansion was no longer

associated with relationship satisfaction. However, self-expansion was still associated

with sexual desire and sexual satisfaction, revealing the importance of sexual desire and

sexual satisfaction within the context of romantic relationships (Muise et al., 2019).

Since self-expansion was no longer associated with relationship satisfaction after three

14
months, this indicates that there are other factors outside of self-expansion and sexual

satisfaction that influence relationship satisfaction.

Relationship Satisfaction

Similar to body image and sexual satisfaction, there are many variables that can

negatively impact people’s satisfaction with their romantic relationship. In the past,

researchers have examined numerous factors that influence relationship satisfaction, such

as financial stress (Totenhagen et al., 2018), negative affect (Sadikaj et al., 2017), and

one’s level of trait mindfulness (Barnes et al., 2007). Relationships can be described

using many adjectives, but a quality relationship is characterized by high levels of

intimacy, satisfaction, trust, commitment, love, and passion (Fletcher et al., 2000).

Body Mass Index and Relationship Satisfaction

Research suggests that heavier women experienced less satisfaction within their

romantic relationships than women with a lower BMI and were less likely to be involved

in a dating relationship. Results also suggested that smaller men experienced less

relationship satisfaction than men with a higher BMI (Sheets & Ajmere, 2005). These

findings are consistent with other researchers (Grieve et al., 2006; Prabhu & d’Cunha,

2018), who suggested that females make attempts to gain a thinner physique, while males

personally prefer a larger physique (Grieve et al., 2006; Prabhu & d’Cunha, 2018).

It was also suggested that body mass index (BMI) is significantly related to

relationship satisfaction within the context of peer relationships (Hoyt & Kogan, 2001).

The researchers hypothesized that individuals who were overweight would be more

dissatisfied with their peer relationships than individuals who were in the normal weight

range. Results suggested that, consistent with predictions, normal weight college-age

15
individuals were more satisfied with their peer relationships than those who were over or

underweight (Hoyt & Kogan, 2001).

Self-Esteem and Relationship Satisfaction

In addition to BMI influencing relationship satisfaction in the context of both

romantic and peer relationships, self-esteem can also be an influential factor. Sciangula

and Morry (2009) were interested in examining whether self-esteem positively predicted

romantic relationship satisfaction. In order to test their prediction, 191 undergraduate

psychology students were recruited to complete a 10-item self-esteem scale and a seven-

item Relationship Assessment Scale. The researchers then conducted a regression

analysis, which produced results that supported their hypothesis. Based on Sciangula and

Morry’s (2009) results, the higher one’s self-esteem, the higher his or her relationship

satisfaction. These findings are relevant in the clinical field to help practitioners

understand that self-esteem indeed influences individual relationship satisfaction reports.

Sciangula and Morry (2009) also found that, in their sample of participants, relationship

status predicted relationship satisfaction. It was previously noted that relationship status

does not predict one’s body image satisfaction (Hoyt & Kogan, 2001), but in this study,

whether one was dating, engaged, or married influenced his or her relationship

satisfaction. Individuals who were engaged or married reported higher levels of

relationship satisfaction than those who were only dating (Sciangula & Morry, 2009).

A high self-esteem can benefit individuals in many ways, including within the

context of their romantic relationships. When individuals do not struggle with self-

esteem concerns, they may be more inclined than those with low self-esteem to engage in

behaviors that are deemed self-expanding (Muise et al., 2019). Regardless of the intensity

16
of the activity, self-expanding activities encourage individuals to develop their

perspectives and to engage in worldly experiences. Not only can engaging in self-

expanding activities promote one’s sexual satisfaction, it can positively influence one’s

relationship satisfaction through both partner’s increased sexual desire and sexual

satisfaction (Muise et al., 2019).

Physical Affection and Relationship Satisfaction

Just like all couples have a subjective appraisal of what they believe are

relationship-enhancing and self-expanding behaviors, within the context of each unique

relationship comes various levels of affection given, preferred, and received by each

partner. Gulledge et al. (2003) were interested in studying college students’ preferences

for various types of physical affection (PA) and their relationship satisfaction as a result

of receiving PA. One unique component of this study is that sexual intimacy was omitted

from the measures. It was predicted that individuals who engage in more PA would be

more satisfied in their relationships than those who engage in less PA. It was also

hypothesized that PA would aid in conflict resolution between couples. Researchers

included seven different types of PA (i.e., holding hands, massaging, kissing on the face,

kissing on the lips, stroking, caressing, cuddling), and instructed participants to rank their

most preferred type of PA to their least favorite. Next, participants responded to a seven-

point Likert scale that measured their opinions concerning PA. Lastly, the participants

reported how often they believed that they engaged in each type of PA with their partner

each week (Gulledge et al., 2003).

Results supported the researchers’ hypotheses. Five out of the seven forms of PA

were significantly associated with relationship satisfaction. Of the seven forms of PA

17
listed above, only caressing and holding hands were not associated with relationship

satisfaction. Furthermore, the amount of PA was also associated with easier conflict

resolution (Gulledge et al., 2003). These results show the importance of implementing

PA into relationships, and one thing to consider is that giving and receiving forms of

affection requires self-esteem (Sciangula & Morry, 2009) and the confidence to engage in

relationship-enhancing behaviors (van den Brink et al., 2018). Because one’s

relationship satisfaction is predicted by PA, it is important to help individuals reach a

level of confidence in which they feel comfortable giving and receiving affection.

Social Support and Relationship Satisfaction

Another form of affection given and received by individuals within a romantic

relationship is support provided in emotional and informational ways (Lorenzo et al.,

2018). Again, developing an intimate connection to another human being requires the

confidence to be vulnerable and engage in the necessary behaviors to be a supportive and

loving partner. It is important that individuals have sufficient confidence in their

interpersonal abilities so that they can provide their partners with physical affection

(Gulledge et al., 2003) and emotional support (Lorenzo et al., 2018). Overall, individuals

who are provided with an overprovision of social support from their significant other

report higher levels of relationship satisfaction than those whose social support

preferences are not met. Lorenzo et al. (2018) were interested in determining whether

individuals’ preferences for social support were associated with their relationship

satisfaction. The two types of social support analyzed in this study were emotional

support and informational support. Lorenzo et al. (2018) predicted that an

underprovision of social support would be associated with lower levels of relationship

18
satisfaction. Data collected and analyzed from 114 newlywedded heterosexual couples

revealed gender differences in the type of social support preferred. The wives in the

study reported that they preferred more of both emotional and informational support, and

husbands indicated that they preferred more emotional support (Lorenzo et al., 2018).

Further results did not entirely support the hypothesis. An underprovision of

emotional support was not necessarily related to lower relationship satisfaction, because

people’s preference for emotional support did not influence their relationship satisfaction.

There was, however, a significant relationship between emotional support and

relationship satisfaction for both genders, suggesting that the more emotional support

given and received, the higher the relationship satisfaction, regardless of preferences

(Lorenzo et al., 2018). Results also revealed that the wives in this study reported higher

relationship satisfaction when they received higher levels of informational support.

There was no relationship between informational support and relationship satisfaction for

the husbands in this study, indicating that the perceived value of informational support

varies across gender (Lorenzo et al., 2018). These findings suggest that if an individual

in a romantic relationship is struggling with a personal concern, such as body image

dissatisfaction, there are positive implications of providing emotional and informational

support to buffer against the potential relationship problems.

Sexual Satisfaction and Relationship Satisfaction

In addition to BMI, self-esteem, and various forms of support, a woman’s

subjective appraisal of her sexual attractiveness also predicts relationship satisfaction. In

their study, Meltzer and McNulty (2010) were interested in determining whether

women’s body image predicted husband and wife marital satisfaction. They predicted

19
that increased sexual frequency and sexual satisfaction would mediate the relationship

between wives’ perceived sexual attractiveness and marital satisfaction in both partners.

They collected data from 53 newlywedded couples, who had a mean age of 24.85 years

old, who completed self-report measures assessing for frequency of sexual intercourse,

sexual satisfaction, and marital satisfaction (Melzer & McNulty, 2010). The wives in the

study completed additional demographic measures and a body esteem measure. The

researchers were particularly interested in determining which of the three specific

subscales of the Body Esteem Scale (BES; see Franzoi & Shields, 1984) predicted marital

satisfaction the best.

Results from multiple regression analyses revealed that, out of the Sexual

Attractiveness, Weight Concern, and Physical Condition subscales, wives’ perceived

sexual attractiveness was the only subscale that significantly predicted wives’ and

husbands’ marital satisfaction. These results suggest that, when women feel sexually

appealing to partners, they will be more inclined to engage in more frequent sexual

intercourse, which is associated with higher levels of sexual satisfaction for both partners.

Results reveal that both body image and sexual satisfaction are important components in

the context of romantic relationship. Ultimately, Meltzer and McNulty (2010) concluded

that both sexual frequency and sexual satisfaction mediated the relationship between

wives’ body image appraisals and wives’ and husbands’ marital satisfaction.

Another study conducted by van den Brink et al. (2018) produced very similar

results. Because of the results revealed in Meltzer & McNulty’s (2010) research, this

group of researchers wanted to extend previous findings by including both members of

the couple and adopting a dyadic approach. They collected data from 151 Dutch couples,

20
with a mean age of 23.14 years old. They predicted that sexual satisfaction would again

mediate the relationship between body image and relationship quality. After conducting

analyses utilizing actor-partner interdependence models, the researchers concluded that,

before accounting for sexual satisfaction, there was a relationship between body image

and couples’ relationship satisfaction. Once sexual satisfaction was added to the model

as a mediator, the relationship between the predictor and outcome variables was no

longer significant, suggesting that sexual satisfaction indeed mediates the relationship.

van den Brink et al. (2018) also found that one actor’s body image and sexual satisfaction

predicted his or her own relationship satisfaction, but did not predict his or her partner’s

relationship satisfaction. There were no gender differences in their findings. These

results show that, within both genders, it is important to promote healthy body image

appraisals and sexual practices, so that there is a higher likelihood of relationship

satisfaction for both members in the relationship (van den Brink et al., 2018).

Perceived Valuation and Relationship Satisfaction

In another intricate study that was conducted by Meltzer and McNulty (2014), the

goal was to explore the role of a romantic partner’s body evaluation, commitment level,

and evaluation of non-physical qualities about his or her partner and how this affects each

gender’s relationship satisfaction (Meltzer & McNulty, 2014). Meltzer and McNulty

(2014) published an in-depth study, with the purpose of providing information regarding

even more variables influencing relationship satisfaction, in addition to body image and

sexual satisfaction (Meltzer & McNulty, 2010). In their first study, the researchers

wanted to determine whether the extent to which women think their partner values them

for their bodies and non-physical qualities and their partner’s level of commitment affect

21
their relationship satisfaction. The 108 participants were first-year undergraduate

Psychology students who were currently engaged in romantic relationships. It was

predicted that women who believe that their boyfriends value their bodies would

experience higher relationship satisfaction only when their boyfriends were also

committed partners and valued them for their nonphysical characteristics. Further, it was

predicted that they would experience lower levels of relationship satisfaction when they

did not believe that their boyfriends value them for nonphysical qualities or were not

committed (Meltzer & McNulty, 2014).

To assess for perceived body valuation, nonphysical valuation, and level of

partner commitment, the researchers developed one-item Likert scale measures that were

all high in face validity. In order to measure relationship satisfaction, the researchers

assessed global relationship satisfaction using the Semantic Differential (SMD), which is

a 15-item measure depicting various sets of contrasting adjectives (i.e., good – bad) that

allows respondents to evaluate their relationship using a 7-point Likert scale (Meltzer &

McNulty, 2014). To see if there was an effect of all of these variables on relationship

satisfaction, the researchers regressed women’s relationship satisfaction onto their scores

of perceived body valuation, nonphysical valuation, and partner commitment level.

Results of the regression analysis revealed that, as predicted, women experienced higher

levels of relationship satisfaction when they believed their partners valued their bodies

but also believed that they were in a committed relationship and valued for nonphysical

qualities. Ultimately, body valuation is an influential component of women’s

relationship satisfaction, but it is not sufficient on its own to ensure women’s overall

happiness in their relationships (Meltzer & McNulty, 2014).

22
 To include results concerning men’s relationship satisfaction, the researchers

replicated their first study, except with male participants. Unlike the first study, though,

there were no predictions made concerning men’s relationship satisfaction, and the

research was mainly exploratory. The research question remained the same and aimed to

determine whether the degree that men think their partner values them for their bodies

and non-physical qualities and their partners’ levels of commitment affects their

relationship satisfaction. The 40 male participants were once again first-year Psychology

students. Just like the first study, the male students completed the SMD to assess for

relationship satisfaction and the one-item questionnaires pertaining to all other variables:

perceived body valuation, nonphysical valuation, and commitment level (Meltzer &

McNulty, 2014).

Another regression analysis was completed to examine the interactive effects of

these variables, and results surprisingly revealed that men who perceived high levels of

body valuation actually experienced less relationship satisfaction when they were less

valued for their nonphysical qualities. This result could be explained by the proposition

that objectification theory also applies to men and that men simply feel like sex objects

when they are not valued for other qualities as well (Meltzer & McNulty, 2014). In

essence, men are similar to women in that they prefer to be valued in a nonphysical

manner in order to experience the greatest amount of relationship satisfaction. Unlike

women, however, men do not experience differing degrees of relationship satisfaction

when their partner is committed or uncommitted (Meltzer & McNulty, 2014).

These findings demonstrate that not only does body image, self-esteem, BMI,

social support, and sexual satisfaction affect relationship satisfaction, but so do other

23
interactive variables. Meltzer and McNulty’s (2014) study adds more data to the present

research regarding relationship satisfaction and its numerous influences.

Limitations of Existing Research

Although an abundance of literature described above provides insight into the

topics of body image, sexual satisfaction, and relationship satisfaction, there are areas

that merit further study and investigation. For example, several of the aforementioned

studies provide findings relevant to adolescent and college-age samples, and their

findings cannot be generalized to samples of the broader population (Hoyt & Kogan,

2001; Prabhu & D’Cunha, 2018). Due to researchers often using a convenience sample

of college students, there is a need for research collecting data from individuals in other

age groups, such as older adults. Some researchers (Meltzer & McNulty, 2010; van den

Brink et al., 2018) included participants who were in their mid-20s, but also

recommended that future studies incorporate participants who are well into their

adulthood experience.

Another limitation that exists within the currently published literature, especially

within the topics of body image and sexual satisfaction, is the widespread use of female

research participants. Several researchers in the past have been more interested in

female, as compared to male, perspectives regarding body image, since women are

historically more dissatisfied with their body image than men (Ackard et al., 2000).

Because females are more commonly studied within this research topic, it is necessary for

future researchers to include males within their sample and to make specific predictions

regarding gender differences (Meltzer & McNulty, 2010; Pujols et al., 2010). In addition

to the sparse number of male participants compared to female participants in previous

24
research, some scholars have only included heterosexual individuals in their samples of

participants. Researchers recommend recruiting a more representative sample of the

population, including individuals of all sexual orientations (van den Brink et al., 2018).

In addition to the literature gaps pertaining to the age of participants and the use

of both male and female participants, there are gaps in the literature regarding other

methods utilized. For instance, some of the studies reviewed did not use measures that

included previously established psychometric properties, such as reliability or validity

coefficients. Rather than include measures with questionable psychometric properties,

researchers suggest incorporating psychometrically sound and previously published

measures into future studies (Ackard et al., 2000; Friedman & Dixon, 1999).

Furthermore, some researchers chose to include single-item measures that were high in

face validity. Researchers suggest that using multiple-item comprehensive measures will

provide more valid and reliable findings (Meltzer & McNulty, 2014; van den Brink et al.,

2018).

Rationale for the Current Study

Because psychological well-being is positively associated with healthy

functioning within romantic relationships (Davila et al., 2017), it is important for

healthcare professionals to consider the factors that influence mental health. Individual

psychological well-being is a complex construct, and can certainly encompass variables

such as body image appraisals and sexual satisfaction (van den Brink et al., 2018). As

described previously, some researchers posit that individuals who have higher body

esteem are more likely than those with lower body esteem to engage in relationship-

enhancing behaviors, such as sexual intercourse. Researchers have also suggested that

25
increased frequency of sexual intercourse and sexual satisfaction are necessary

components of relationship satisfaction (Meltzer & McNulty, 2010; van den Brink et al.,

2018). Therefore, individuals who have positive body image appraisals could indirectly

be more likely to experience relationship satisfaction through the pathways of high body

esteem and sexual satisfaction (Meltzer & McNulty, 2010; van den Brink et al., 2018).

The current study is designed to analyze the relationship between three variables:

body image, sexual satisfaction, and relationship satisfaction. Ultimately, the goal of the

current study is to determine whether body image satisfaction and sexual satisfaction

predict romantic relationship satisfaction. It is hypothesized that body image satisfaction

and sexual satisfaction will work together to positively predict relationship satisfaction.

Further, it is hypothesized that sexual satisfaction will mediate the association between

body image satisfaction and relationship satisfaction. To fill gaps in the existing

literature, the present study will incorporate previously published psychometrically sound

measures for all variables, will incorporate adult men into the study, and will analyze an

older sample of the adult population.

26
 Chapter II

Methods

Participants

All volunteer participants were recruited from Amazon’s Mechanical Turk

(MTurk) database. The current study aimed to recruit 200 participants, and ultimately

analyzed data from 198 participants (N = 198) after two participants failed to complete

sufficient survey material.

Participants’ ages ranged from age 25 to 70 (M = 34.68, SD = 10.54), and their

relationship lengths ranged from 3 months to 500 months (M = 67.54, SD = 97.77).

Participants’ overall BMI was calculated and exhibited wide variability (M = 25.4, SD =

9.41). A majority of participants reported that they were married (56%), but others

indicated that they were dating (34%) and engaged (10%). There was also ethnic

variability in the sample, with participants identifying as African American (4%), Asian

American (21%), White/Non-Hispanic (38%), White/Hispanic (27%), and Other (10%).

The sample was highly educated, with a majority of participants having obtained a

bachelor’s degree (60%). Further, a portion of the sample earned a high school diploma

(8%), associate degree (10%), master’s degree (20%), and doctorate (2%). Lastly, there

was impressive variability in the sexual orientation of the sample, with participants

identifying as heterosexual (76%), homosexual (5%), and bisexual (19%). Table 1

displays participants’ demographic characteristics and the number of participants (n) who

fell into each category.

27
Table 1
Participant Demographic Characteristics
Characteristic n (%)
Gender
Male 99 (50)
Female 99 (50)
Marital Status
Dating 67 (34)
Engaged 19 (10)
Married 110 (56)
Sexual Orientation
Heterosexual 151 (76)
Homosexual 10 (5)
Bisexual 37 (19)
Highest Education Level
High School Diploma 16 (8)
Associate degree 20 (10)
Bachelor’s Degree 118 (60)
Master’s Degree 40 (20)
Doctorate 4 (2)
Race/Ethnicity
African American 8 (4)
Asian American 42 (21)
White/Hispanic 53 (27)
White/Non-Hispanic 75 (38)
Other 20 (10)
Body Mass Index
Underweight 13 (7)
Normal Weight 150 (76)
Obese 35 (8)

Design and Data Analysis

The design for this study was a cross-sectional survey methodology and the

statistical analysis used to conduct the study was a hierarchical model of regression. The

multiple linear regression was conducted using the IBM SPSS Statistics platform. The

independent variables under study were body image satisfaction, which was measured by

scores on the Body Assessment Scale (Lorenzen et al., 2004), and sexual satisfaction,

28
which was measured by scores on the Index of Sexual Satisfaction (ISS; Hudson, 1998).

The dependent variable under study was romantic relationship satisfaction, which was

assessed using the Relationship Assessment Scale (Hendrick, 1988; Vaughn & Baier,

1999).

Measures

Demographics

Participants’ demographic data such as age, gender, race, sexual orientation,

educational level, and relationship length was collected by using a self-report

questionnaire. See Appendix A.

Body Assessment Scale

To measure participants’ levels of body satisfaction, participants completed the

Body Assessment Scale (BAS; Lorenzen et al., 2004). The BAS is a 25-item scale that

was developed to measure overall global body satisfaction by focusing on individuals’

current satisfaction with various parts of their body (i.e., legs, stomach). Participants are

asked to rate their satisfaction of specific body parts using a five-point Likert-type scale

ranging from 1 (strongly negative) to 5 (strongly positive). Higher total scores indicate

greater global body satisfaction. The BAS has been found to have a strong internal

consistency reliability coefficient of .94 (Lorenzen et al., 2004). See Appendix B.

Index of Sexual Satisfaction

The Index of Sexual Satisfaction (ISS; Hudson et al., 1981) was used to assess

participants’ level of sexual satisfaction within their romantic relationship with their

partners. The ISS is a 25-item measure, and participants indicate the extent to which the

items portray their current level of satisfaction with their sexual relationship. Items are

29
answered with a seven-point Likert scale ranging from 1 (none of the time) to 7 (all of the

time). The higher the ISS score, the more likely it is that participants experience a

clinically significant concern associated with their sex life. Scores below 30 (±5) are

normal and suggest sexual satisfaction. Higher scores suggest that there is possibility of a

clinically significant sexual concern. Scores above 70 indicate significant sexual stress

and possible violence within the sexual relationship. A sample item on the ISS is, “Our

sex life is monotonous” (Hudson, 1998). The ISS has been found to have strong internal

consistency reliability coefficients of .93 for males, and .96 for females (Hudson, 1998;

Meltzer & McNulty, 2010). See Appendix C.

Relationship Assessment Scale

The Relationship Assessment Scale (RAS; Hendrick, 1988; Vaughn & Baier,

1999) was used to assess participants’ relationship satisfaction with their romantic

partner. The RAS is a seven-item scale used to measure general relationship satisfaction.

Participants will answer each item on a five-point Likert scale ranging from 1 (low) to 5

(high). The higher the RAS score, the more satisfied the participant is with his/her

relationship. A sample item on the RAS asks participants, “How much do you love your

partner?” (Hendrick, 1988; Vaughn & Baier, 1999). The RAS has been shown to have

high internal consistency (a = .91) as well as strong concurrent validity with the Dyadic

Adjustment Scale (DAS; Spanier, 1976), which measures marital quality, adjustment, and

satisfaction. See Appendix D.

30
Procedures

Participants accessed the study via the online MTurk database. Participants were

invited to partake in an online study analyzing “various factors that impact romantic

relationships,” and the study was completed during one sitting and entirely online.

Participants were not required to be Mechanical Turk Masters (MTMs), who are

individuals considered to be Amazon’s most quality workers (Lovett et al., 2018). All

participants were presented with an implied consent document (See Appendix E), where

confidentiality and anonymity were emphasized. After reading the implied consent and

agreeing to participate in the study, participants were allowed to continue to the

questionnaire if they met two inclusion criteria. Participants were required to be 25 years

or older and in a romantic relationship lasting three months or longer.

Next, participants completed a demographic questionnaire and reported on basic

demographic features such as age, gender, race, educational level, sexual orientation, and

relationship length. Next, they completed the self-report measures assessing for body

image satisfaction, sexual satisfaction, and relationship satisfaction. The BAS, ISS, and

RAS were counterbalanced to avoid order effects and the study took participants

approximately 10 to 20 minutes to complete. Participants were debriefed (See Appendix

F) and compensated 50 cents for their participation.

31
 Chapter III

Results

Preliminary Analyses

Participants responded to the BAS, ISS, and RAS. Scores were summed to

determine participants’ total body assessment score, index of sexual satisfaction score,

and relationship satisfaction scores. Participant scores on the BAS ranged from a score of

25 to 125 (M = 87.66, SD = 21.26), with a possible range of 25 to 125. Scores on the ISS

ranged from a score of 4 to 75 (M = 34.374, SD = 16.89), with a possible range of 0 to

100, with lower scores indicating greater sexual satisfaction, and higher scores indicating

a greater likelihood of a clinically significant problem within the sexual relationship.

Lastly, participant scores on the RAS ranged from 8 to 35 (M = 26.81, SD = 16.89), with

a possible range of 7 to 35. Cronbach’s alpha values were also calculated for each

measure using the current sample of participants. Table 2 displays the aforementioned

descriptive statistics pertaining to the three measures.

Table 2
BAS, ISS, and RAS Descriptive Statistics
Cronbach’s Absolute Absolute Minimum Maximum M SD
Alpha Minimum Maximum
BAS .97 25 125 25 125 87.66 21.26

ISS .92 0 100 4 75 34.37 16.89

RAS .84 7 35 8 35 26.81 5.64

Note. BAS = Body Assessment Scale; ISS = Index of Sexual Satisfaction; RAS =
Relationship Assessment Scale; Absolute Minimum = the lowest possible score that a
participant can score on a given measure; Absolute Maximum = the highest possible
score that a participant can score on a given measure.

32
Hypothesis Testing

A hierarchical model of regression was used to predict romantic relationship

satisfaction from level of body image satisfaction and sexual satisfaction. It was

predicted that sexual satisfaction would mediate the relationship between body image and

relationship satisfaction. Table 3 displays the descriptive statistics and Table 4 contains

the results of the regression. Body image was placed into Block 1, because it is believed

that it is a precursor to sexual satisfaction, which was placed into Block 2. For clarity

purposes, sexual satisfaction is depicted in the following tables as “Sexual Concern,” due

to the opposite direction of the scores, where lower scores indicate greater satisfaction.

Results indicated that the combined predictors accounted for a significant proportion of

variance, where 65% of the variance in relationship satisfaction was related to body

image and sexual satisfaction, F(2,195) = 182.96, p < .001.

Table 3
Relationship Satisfaction, Body Assessment, and Sexual Concern Correlations and
Descriptive Statistics
1 2 3

1. Relationship Satisfaction --- .22** -.79**

2. Body Image --- -.04

3. Sexual Concern ---

N 198 198 198

M 26.81 87.66 34.37

SD 5.64 21.26 16.89

Note. ** denotes significant correlations < .01.

1. Criterion Variable: Relationship Satisfaction
2. Predictor Variable: Body Image
3. Predictor Variable: Sexual Satisfaction

33
Table 4
Relationship Satisfaction Predicted by Body Image Satisfaction and Sexual Satisfaction
Predictor R2 b SE b
Step 1 .05**
Constant 21.67 1.67
Body Image .06 .02 .22
Step 2 .60**
Constant 31.38 1.14
Body Image .05 .01 .19
Sexual Concern -.26 .01 -.78
Total R2 .65**

Note. ** denotes significance < .01

Relationship satisfaction was positively predicted by body image t(195) = 4.44, p

< .001, and was negatively predicted by sexual concerns t(195) = -18.40, p < .001. As

body image satisfaction increased, relationship satisfaction also increased. Furthermore,

as sexual concerns decreased, relationship satisfaction increased. When sexual

satisfaction was added into the hierarchical model, body image remained a significant

predictor of relationship satisfaction, therefore indicating that sexual satisfaction did not

mediate the association between body image and relationship satisfaction. Mediation

occurs when the significant association between the first predictor variable and the

outcome variable no longer exists after the second predictor is added into the model. The

two predictors together accounted for a larger proportion of variance (65%) than just

body image (5%) or sexual satisfaction (60%) alone. In summary, because the two

predictor variables were not significantly correlated, they are both independent

contributors to relationship satisfaction. Ultimately, as body image increases and sexual

concerns decrease, relationship satisfaction increases.

34
 Chapter IV

Discussion

Previous research suggests that healthily functioning romantic relationships have

positive implications for individuals’ psychological well-being, such as lower levels of

anxiety and depression, as well as improved competency with decision-making (Davila et

al., 2017). Because individuals from numerous demographic backgrounds seek

psychological services for a host of reasons, including concerns regarding interpersonal

relationships, the present study was designed to analyze relevant factors that impact

romantic relationship satisfaction in adults. It was hypothesized that body image, as

measured by the Body Assessment Scale (Lorenzen et al., 2004), would positively predict

relationship satisfaction, as measured by the Relationship Assessment Scale (Hendrick,

1988; Vaughn & Baier, 1999). Further, it was hypothesized that sexual satisfaction, as

measured by the Index of Sexual Satisfaction (Hudson et al., 1981), would also positively

predict relationship satisfaction. Lastly, it was predicted that sexual satisfaction would

mediate the association between body image and relationship satisfaction.

Results supported the first hypothesis, and body image positively predicted

relationship satisfaction. Overall, participants were satisfied with their body image, as

they scored, on average, above the split-scale mean, given the minimum possible score of

25 and the maximum possible score of 125. These findings are in-line with widely-cited

previous research conducted by Friedman et al. (1999), who found that there is a positive

association between body image and marital satisfaction, with individuals who were more

satisfied in their marriages reporting higher body image satisfaction than those who

reported lower martial satisfaction. Furthermore, in a sample of college-age participants,

35
it was suggested that a similar relationship exists. Hoyt and Kogan (2001) found that

individuals who reported greater relationship satisfaction reported higher body image

satisfaction than those who reported lower relationship satisfaction. Although causality

and directionality cannot be assumed given the correlational nature of these studies, there

is preexisting and current data to suggest a significant association between body image

and relationship satisfaction in samples of the population ranging from dating college-age

participants (Hoyt & Kogan, 2001) to married adults (Friedman et al., 1999) to the

current study, which incorporated participants all over the age of 25.

Results of the present study also supported the second hypothesis, which stated

that sexual satisfaction would predict relationship satisfaction. Within the context of

romantic relationships, sexual functioning and satisfaction has been plentifully studied.

Similar to past findings, which suggested that increased sexual satisfaction is associated

with relationship satisfaction (Meltzer & McNulty, 2010; van den Brink et al., 2018),

results of the current study added more evidence to the literature to support this claim.

Ultimately, the current study’s results show that healthy sexual practice is a predictor of

romantic relationship satisfaction in this adult sample.

Results did not support the last hypothesis, which predicted that sexual

satisfaction would mediate the relationship between body image and relationship

satisfaction. Sexual satisfaction has been a popularly studied variable when examining

romantic relationships, and it has commonly been analyzed as a mediating variable

between the constructs of body image and relationship satisfaction (Meltzer & McNulty,

2010; van den Brink et al., 2018), and between self-expansion and relationship

satisfaction (Muise et al., 2018). Because sexual satisfaction has played a mediating role

36
in previous research, it was predicted that it would again mediate the relationship

between body image and relationship satisfaction.

Although both body image and sexual satisfaction indeed predicted relationship

satisfaction, sexual satisfaction did not mediate this association. Both predictors were

independent contributors to relationship satisfaction because body image remained a

significant predictor of relationship satisfaction, even after sexual satisfaction was added

to the model. These findings contrast previous work conducted by Meltzer and McNulty

(2010), who found that wives’ perceived sexual attractiveness, a component of body

esteem, predicted relationship satisfaction through the variables of sexual satisfaction and

sexual frequency. Once sexual satisfaction and sexual frequency were accounted for,

wives’ body esteem no longer predicted relationship satisfaction, showing that the sexual

components subsumed the first model and mediated the relationship between wives’ body

esteem and relationship satisfaction (Meltzer & McNulty, 2010).

Similar to these findings, van den Brink et al. (2018) concluded that individuals

who report higher body image also report higher sexual satisfaction, and therefore higher

relationship satisfaction than individuals who report lower body image. The association

between body image and relationship satisfaction was no longer significant after

accounting for sexual satisfaction in both male and female participants (van den Brink et

al., 2018). There could be a host of reasons why the results of the current study did not

have similar findings in regard to the mediating variable. For instance, differences in the

measures used could influence findings, as well as the sample of the population analyzed.

Both Meltzer and McNulty (2010) and van den Brink et al. (2018) analyzed younger

samples of adults with mean ages of 25.8 years old and 23.1 years old, respectively;

37
whereas, the current study had a higher mean age of participants (M = 34.68, SD =

10.54).

The difference in age groups could suggest that, as individuals get older, sexual

satisfaction is still important for relationship satisfaction, but it does not mediate the

association between body image and relationship satisfaction, suggesting that older

individuals are inclined to engage in relationship-enhancing behaviors, such as sexual

intercourse, despite their bodily appraisals. This rationale makes sense, when considering

findings from Schneider and Grimps (2013), who found that married individuals

exhibited a higher BMI than individuals who were single or never married. They also

noted that, even after holding participants’ age constant, participants’ BMI slightly

increased with each year of marriage. They theorized that, as years progress and the

likelihood of divorce decreases, individuals invest less time in obtaining the ideal body

image (Schneider & Grimps, 2013). Perhaps, once individuals reach a certain level of

trust and commitment to their partner, which are components of a quality relationship

(Fletcher et al., 2000), they are confident in their partner’s acceptance of them and

proceed with relationship-enhancing behaviors (van den Brink et al., 2018) despite body

image concerns.

Although the results from the present study indicated that there is a significant,

positive relationship between the predictor and criterion variables, there were some

limitations worth noting. For instance, MTurk was utilized as a convenience sampling

technique, and individuals who regularly participate in online research may have

personality traits that differ from others who do not actively engage in the furthering of

academic research. For instance, this sample of individuals was highly educated, and the

38
current findings may not generalize to another sample of the population with different

demographic characteristics. However, this possible limitation was considered, and

research suggests that MTurk not only reaches a wider geographical pool of participants

that is more representative of the national population as a whole, but that MTurk workers

provide reliable, high-quality responses that are comparable to responses collected in the

laboratory setting (Lovett et al., 2018).

Another possible limitation could be the simplistic linear regression design.

While it is not possible to determine causality in quasi-experimental designs, a more in-

depth statistical analysis could help identify other pathways to relationship satisfaction or

any confounding variables, such as BMI. Future researchers should consider replicating

the current study and making unique predictions using other statistical models. Cross-

sectional and longitudinal designs are required to answer certain research questions

pertaining to the directionality of the variables. The current study included individuals

who identified as homosexual and bisexual, which was not a common occurrence in

previous literature. However, no specific predictions were made about this population,

and future researchers should consider collecting data regarding factors that could

uniquely influence LGBTQ relationships.

Along with the limitations, there are also notable strengths about the current

study, and gaps in the literature which the current study helped fill. For instance,

previous researchers utilized single-item measures, which are not as reliable as

comprehensive, previously-established study measures (Meltzer & McNulty, 2010; van

den Brink et al., 2018). To enhance the quality of research in this area, the current study

utilized psychometrically-sound comprehensive measures to assess for all variables. Past

39
researchers also called for a need of older adult participants (Hoyt & Kogan, 2001;

Meltzer & McNulty, 2010; van den Brink et al., 2018), and the current study took this

into consideration when requiring that participants must be 25 years or older. In addition,

the current study included both male and female participants, because evidence suggests

that men also experience body image concerns at a similar level to females (Grieve et al.,

2006), which could impact other areas of functioning, such as sexual intercourse or

relationship satisfaction.

Ultimately, these findings provide healthcare professionals with practical

implications in the scope of clinical practice. With this knowledge, clinicians can explore

issues related to body image or sexual satisfaction that could impede relationship

satisfaction. Furthermore, healthcare providers can help clients address the underlying

concerns within their relationship through techniques geared toward improving body

image and sexual functioning.

Because engaging in healthy romantic relationships promotes healthy

psychological functioning (Davila et al., 2017), the current study was valuable in the

expansion of the body of research pertaining to this topic. If clients can develop accurate

bodily appraisals and address these concerns, as well as address any sexual concerns,

there is hope that these individuals can engage in satisfactory romantic relationships, and

experience an overall improvement in their mental health.

40
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 Appendix A
Demographics Questionnaire and Qualifying Items

1. Are you currently in a romantic relationship lasting three months or longer?

a. Yes
b. No

2. If you answered “yes” to the above item, how long (in months) have you been in
this relationship? ____________

3. Are you 25 years or older?

a. Yes
b. No

4. Age ___________

5. Gender
a. Male
b. Female
c. Other __________

6. Height, in inches _______

7. Weight, in pounds ________

8. Race/Ethnicity
a. African American
b. Asian American
c. White, non-Hispanic
d. White, Hispanic
e. Middle Eastern
f. Other ___________

9. Highest academic status achieved

a. Less than high school diploma
b. High school diploma
c. Associate’s Degree
d. Bachelor’s Degree
e. Master’s Degree
f. Doctorate
g. Other __________

10. Sexual Orientation

a. Heterosexual

48
b. Homosexual
c. Bisexual
d. Other __________
e. Prefer not to answer

49
 Appendix B
Body Assessment Scale

Rate the following areas on a scale of 1 (strongly negative) to 5 (strongly positive).

1. _____ Weight
2. _____ Face
3. _____ Body shape
4. _____ Thighs
5. _____ Upper body strength
6. _____ Waist
7. _____ Reflexes
8. _____ Health
9. _____ Shoulders
10. _____ Physical stamina
11. _____ Agility
12. _____ Biceps
13. _____ Lower body strength
14. _____ Chest
15. _____ Chin
16. _____ Energy level
17. _____Body build
18. _____ Physical coordination
19. _____ Buttocks
20. _____ Calves
21. _____ Stomach
22. _____ Physical condition
23. _____ Triceps
24. _____ Abdominal muscles
25. _____ Legs

50
 Appendix C
Index of Sexual Satisfaction

This questionnaire is designed to measure the degree of satisfaction you have in the
sexual relationship with your partner. It is not a test, so there are no right or wrong
answers. Answer each item as carefully and as accurately (honestly) as you can by
placing a number beside each one as follows.

1 = None of the time

2 = Very rarely
3 = A little of the time
4 = Some of the time
5 = A good part of the time
6 = Most of the time
7 = All of the time

1. ______ I feel that my partner enjoys our sex life.

2. ______ Our sex life is very exciting.
3. ______ Sex is fun for my partner and me.
4. ______ Sex with my partner has become a chore for me.
5. ______ I feel that our sex is dirty and disgusting.
6. ______ Our sex life is monotonous.
7. ______ When we have sex it is too rushed and hurriedly completed.
8. ______ I feel that my sex life is lacking in quality.
9. ______ My partner is sexually very exciting.
10. _____ I enjoy the sex techniques that my partner likes or uses.
11. _____ I feel that my partner wants too much sex from me.
12. _____ I think that our sex is wonderful.
13. _____ My partner dwells on sex too much.
14. _____ I try to avoid sexual contact with my partner.
15. _____ My partner is too rough or brutal when we have sex.
16. _____ My partner is a wonderful sex mate.
17. _____ I feel that sex is a normal function of our relationship.
18. _____ My partner does not want sex when I do.
19. _____ I feel that our sex life really adds a lot to our relationship.
20. _____ My partner seems to avoid sexual contact with me.
21._____ It is easy for me to get sexually excited by my partner.
22. _____ I feel that my partner is sexually pleased with me.
23. _____ My partner is very sensitive to my sexual needs and desires.
24. _____ My partner does not satisfy me sexually.
25. _____ I feel that my sex life is boring.

51
 Appendix D
Relationship Assessment Scale

Select the answer that best describes your belief regarding your current romantic
relationship.

1. How well does 1 2 3 4 5

your partner meet Poorly Average Extremely
your needs? Well
2. In general, how 1 2 3 4 5
satisfied are you Unsatisfied Average Extremely
with your Satisfied
relationship?
3. How good is your 1 2 3 4 5
relationship Poor Average Excellent
compared to most?
4. How often do you 1 2 3 4 5
wish you hadn’t Never Average Very
gotten in this Often
relationship?
5. To what extent has 1 2 3 4 5
your relationship Hardly At Average Completely
met your original All
expectations?
1 2 3 4 5
6. How much do you
Not Much Average Very
love your partner? Much
7. How many 1 2 3 4 5
problems are there Very Few Average Very
in your Many
relationship?

52
 Appendix E
Implied Consent Document

53
54
 Appendix F
Debriefing Statement

Thank you for your participation in this study. Your participation will aid in the
understanding of factors that influence romantic relationships in adults. Please enter
survey code "Western2020" into the box below the survey link upon completion.

Please contact the investigator, Hannah Krisher, at [email protected]

with any questions.

55