Repressive coping style and its relation to psychosocial distress in males with erectile dysfunction

There is evidence that repressive coping adversely affects medical conditions such as coronary heart disease, hypertension, and bronchial asthma. Erectile dysfunction (ED) is known to have a severe and lasting negative impact on health, quality of life, and partnership. Although ED may be eminently threatening for the self-image of affected men, a repressive coping style and its consequences for their mental health and partnership has not yet been investigated.

Based on the presumption that the male self-image is threatened by ED, we expected men with repressive coping strategies-although reporting the same degree of impairments regarding their sexual function-to describe themselves as more satisfied with: (i) their sexual relationship, to report (ii) a better quality of their partnership; and (iii) less distress (depression and physical complaints) as compared with those who do not use such strategies.

Fifty-nine patients with ED from the outpatient unit of the Clinic of Urology, Pediatric Urology and Andrology of the University of Giessen were examined using standardized German versions of international questionnaires. Coping style was determined using a combination of the State Trait Anxiety Inventory (STAI) and the Marlowe Crown Social Desirability Scale (SDS-CM) measuring defensiveness.

Questionnaires measuring anxiety (STAI), depression (Center for Epidemiological Studies Depression Scale), social desirability (SDS-CM), quality of partnership (Partnership Questionnaire), and physical complaints (Complaint List) were administered.

Repressors did not differ from nonrepressors with regard to their self-reported sexual function (International Index of Erectile Function). However, they described themselves as less distressed (depression, physical complaints) and rated the quality of their partnership as higher.

Repressors tend to report their complaints in a manner that protects their self-worth. Clinicians therefore might have difficulties deciding whether and which treatment is necessary. Additional clinical information (e.g., interview together with the female partner) or questionnaires might prove useful sources of information on patients' coping style.