People who are either clingy or aloof in relationships are less satisfied sexually, according to a new review that may help therapists better understand and treat couples with sex problems, the researchers said.

The two psychologists at Deakin University in Melbourne, Australia, focused on the types of attachments people form in relationships, also called attachment styles. Past research has shown certain styles, such as a secure or dismissive attachment to partners, may explain why men and women get jealous for different reasons and may even increase the risk of heart attacks.

In the new review, psychology doctoral candidate Christina Stefanou and colleague Marita McCabe examined 15 studies from the United States, Canada, Israel and the United Kingdom that looked at the association between adult attachment and sexual function published over the past two decades. The articles included heterosexual and homosexual individuals in relationships, and they examined two types of adult attachment styles recognized by psychologists since the late 1980s: anxious attachment, in which people act out fears of rejection and abandonment, and avoidant attachment, where individuals are uncomfortable with closeness and dependence. Both of these attachment styles are considered "insecure," in contrast to the "secure" attachment style, which is neither clingy nor aloof.

Both men and women who described insecure attachments were more likely to report lower sexual satisfaction than those who were securely attached. Women with insecure attachment styles also reported less sexual arousal, problems with lubrication and orgasm and pain during sex, while insecurely attached men reported experiencing erectile dysfunction. [The Sex Quiz: Myths, Taboos & Bizarre Facts]

People who were anxiously attached had frequent sex, whereas aloof individuals had sex less often. "Several studies found that anxiously attached individuals equated sex with romantic love and have sex to reduce insecurity and foster intimacy," the researchers write. But in contrast, they added, "avoidantly attached individuals viewed sex and love as distinct components and experience discomfort with intimacy."

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In clingy individuals, these findings may reflect a sexual "hyperactivation" strategy of putting a lot of effort into encouraging a partner to have sex, placing too much importance on sex in a relationship and being hypervigilant about sexual rejection. People with avoidant attachment styles, on the other hand, may be acting out sexual "deactivation," which involves inhibiting sexual desire, arousal and pleasure from orgasm, and distancing one's self from a partner who is interested in sex.

Attachment's early origins

How a person relates to their partner in bed may stem back to their childhood, psychologists say. For instance, early interactions with significant others can instill in children certain expectations and beliefs about loved ones. These, in turn, shape thoughts and behaviors with romantic partners as adults, the researchers write online July 3 in The Journal of Sexual Medicine.

"In fact, experienced psychoanalysts and sex therapists have long explained sexual dysfunction within the context of attachment to parents," they add. [10 Parenting Tips for Raising Happy Kids]

This so-called attachment theory posits that when children feel that their loved ones are available and responsive, they feel safe and develop secure attachments. But when children feel that their parents or other caregivers are inconsistently available, they may form anxious attachments, marked by "anxious clinging or aggression to obtain attention and care," the researchers write. If a loved one is perceived as simply unavailable, children may learn avoidant behaviors, like suppressing their needs and becoming self-reliant.

This shaping of attachment styles begins in infancy, lead researcher Stefanou told LiveScience.

"Attachment bonds are formed primarily in childhood, and this transcends into adulthood impacting all relationships, including friendship, not just romantic relationships," Stefanou said. Based on how the primary caregiver behaves, "infants internalize 'working models,' or perceptions about themselves and others." In fact, studies that have followed individuals for up to 25 years show that attachment styles classified in infancy usually remain stable over time. Even so, life events after infancy, such as a parent’s divorce or death or even an early first love, may change whether a person is securely or insecurely attached in adulthood, Stefanou said.

For better sex ...

Stefanou and her co-author Marita McCabe, director of Deakin's Center for Mental Health and Wellbeing Research, believe their findings could impact how we treat sexual dysfunction. Rather than just dealing with the symptoms, a more successful strategy might also look at whether couples have anxious or avoidant attachment tendencies.

For her doctoral thesis, Stefanou is further examining the association between adult attachment and the different components of sexual function (dysfunction, satisfaction and behaviors) in both men and women of all sexual orientations and in different types of partnerships.

She points out that 50 percent of marriages in the United States result in divorce, which "increases the risk for psychological and physical health problems in both partners." Meanwhile, young married couples say that the frequency of sex is the second biggest problem in their relationship (after satisfaction), and more than half of men and women in a recent survey said that they were dissatisfied with their sex lives. "It is therefore important to better understand the factors related to sexual functioning in romantic relationships."

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