Background: Considering the lack of documented research on the sexuality of dependent persons, this qualitative study examined sexual dynamics among Iranian married women with excessive interpersonal dependency. Methods: Interviews with 18 married women with high interpersonal dependency were coded using thematic analysis. Results: Three major areas emerged from the data under which the themes clustered. These were (1) intrapersonal level which included confused sexual cognitions, intrusive thoughts during sex, preoccupation by sexual thoughts, low tolerance for reduction or interruption of sexual activity, and emotional distress during sex, (2) interactional dynamics including imposing pressure on the husband to have sex and assuming a submissive and receptive role during sex, and (3) contextual processes including social stigma and the effects of social phenomena. Conclusions: These findings presented a relatively clear understanding of the impacts of interpersonal dependency on the sexuality of Iranian women. The majority of the women reported maladaptive sexual strategies, attitudes, and emotions. Moreover, there were several similarities between the sexual dynamics of the women and those of individuals with anxious attachment style. These findings suffer from some limitations in terms of generalization due to the small size of the sample and clinical and cultural considerations. The implications of these findings for practitioners are also considered.

Bornstein RF: The dependent personality: developmental, social, and clinical perspectives. Psycho Bull 1992;112:3-23.
Zuroff DC, Igreja I, Mongrain M: Dysfunctional attitudes, dependency, and self-criticism as predictors of depressive mood states: a 12-month longitudinal study. Cognit Ther Res 1990;14:315-326.
Overholser JC: Interpersonal dependency and social loss. Pers Individ Dif 1992;13:17-23.
Murphy CM, Meyer SL, O'Leary KD: Dependency characteristics of partner assaultive men. J Abnorm Psychol 1994;103:729-735.
Apt C, Hulbert DF, Powel D: Men with hypoactive sexual desire disorder: the role of interpersonal dependency and assertiveness. J Sex Educ Ther 1993;19:108-116.
Lavan H, Johnson JG: The association between axis I and II psychiatric symptoms and high-risk sexual behavior during adolescence. J Pers Disord 2002;16:73-94.
Sealy JR: Psychopharmacologic intervention in addictive sexual behavior; in Carnes PJ, Adams KM (eds): Clinical Management of Sex Addiction. New York, Brunner-Routledge, 2002, pp 199-216.
Ferree MC: Females: the forgotten sexual addicts; in Carnes PJ, Adams KM (eds): Clinical Management of Sex Addiction. New York, Brunner-Routledge, 2002, pp 255-269.
Bornstein RF, Languirand MA: Healthy Dependency: Leaning on Others without Losing Yourself. New York, Newmarket Press, 2003.
Ley DJ: The Myth of Sex Addiction. Lanham, Rowman & Littlefield, 2012.
Alonso-Arbiol I, Shaver PR, Yarnoz S: Insecure attachment, gender roles, and interpersonal dependency in the Basque Country. Pers Relatsh 2002;9:479-490.
Collins NL, Read SJ: Adult attachment, working models, and relationship quality in dating couples. J Pers Soc Psychol 1990;58:644-663.
Blatt SJ, Homann E: Parent-child interaction in the etiology of dependent and self-critical depression. Clin Psychol Rev 1992;12:527-562.
Pincus AL, Wilson KR: Interpersonal variability in dependent personality. J Pers 2001;69:224-251.
Mikulincer M, Shaver PR: Attachment in adulthood: structure, dynamics, and change. New York, Guilford Press, 2007.
Weinstein A, Katz L, Eberhardt H, Cohen E, Lejoyeux M: Sexual compulsion - relationship with sex, attachment and sexual orientation. J Behav Addict 2015;4:22-26.
Impett EA, Gordon AM, Strachman A: Attachment and daily sexual goals: a study of dating couples. Pers Relatsh 2008;15:375-390.
Zapf JL, Greiner J, Carroll J: Attachment styles and male sex addiction. Sex Addict Compulsivity 2008;15:158-175.
Birnbaum GE, Reis HT, Mikulincer M, Gillath O, Orpaz A: When sex is more than just sex: attachment orientations, sexual experience, and relationship quality. J Pers Soc Psychol 2006;91:929-943.
Gheshlaghi F, Dorvashi G, Aran F, Shafiei F, Montazeri G: The study of sexual satisfaction in Iranian women applying for divorce. Int J Fertil Steril 2014;8:281-288.
Sabety Hesary M, Zakariaei Z: Comparison of sexual dysfunction and coping strategies in couples applicants of divorce and normal couples. J Appl Environ Biol Sci 2015;5:228-238.
Hirschfield RM, Klerman GL, Gough HG, Barrett J, Korchin SJ, Chodoff P: A measure of interpersonal dependency. J Pers Assess 1977;41:610-618.
McClintock AS, Anderson T: The application of mindfulness for interpersonal dependency: effects of a brief intervention. Mindfulness 2015;6:243-252.
McClintock AS, Anderson T, Cranston S: Mindfulness therapy for maladaptive interpersonal dependency: a preliminary randomized controlled trial. Behav Ther 2015;46:856-868.
Sharifi M: The study of factors influencing on marital quality of women with interpersonal dependency, and effects of individual and couple counseling on marital quality of them; unpublished doctoral thesis, Isfahan, University of Isfahan, 2017.
Loas G, Corcos M, Perez-Diaz F, Verrier A, Guelfi JD, Halfon O, Jeammet P: Criterion validity of the Interpersonal Dependency Inventory: a preliminary study on 621 addictive subjects. Eur Psychiatry 2002;17:477-478.
Morgan TA, Clark LA: Passive-submissive and active-emotional trait dependency: evidence for a two-factor model. J Pers 2010;78:1325-1352.
Bornstein RF: Construct validity of the Interpersonal Dependency Inventory: 1977-1992. J Pers Disord 1994;8:64-76.
Gholizadeh S: Study of the psychometric properties of Interpersonal Dependency Questionnaire and its relationship with social intimacy. J Educ Manage Stud 2014;4:823-829.
Bryman A: Quantity and Quality in Social Research. London, Unwin Hyman, 1988.
Marques JF, McCall C: The application of interrater reliability as a solidification instrument in a phenomenological study. Qual Rep 2005;10:439-462.
Loas G, Atger F, Perdereau F, Verrier A, Guelfi JD, Halfon O, Lang F, Bizouard P, Venisse JL, Perez-Diaz F, Corcos M, Flament M, Jeammet P: Comorbidity of dependent personality disorder and separation anxiety disorder in addictive disorders and in healthy subjects. Psychopathology 2002;35:249-253.
Chambless DL, Renneberg B, Gracely EJ, Goldstein AJ, Fydrich T: Axis I and II comorbidity in agoraphobia: prediction of psychotherapy outcome in a clinical setting. Psychother Res 2002;10:279-295.
Bornstein RF: From dysfunction to adaptation: an interactionist model of dependency. Annu Rev Clin Psychol 2012;8:291-316.
Coleman E: Is your patient suffering from compulsive sexual behavior? Psychiatr Ann 1992;22:320-325.
Huprich S, Rosen A, Kiss A: Manifestations of interpersonal dependency and depressive subtypes in outpatient psychotherapy patients. Personal Ment Health 2013;10:102-122.
Opitz D, Tsytsarev S, Froh JJ: Women's sexual addiction and family dynamics, depression and substance abuse. Sex Addict Compulsivity 2009;16:324-340.
Mehta CM, Walls C, Blood EA, Shrier LA: Associations between affect, context, and sexual desire in depressed young women. J Sex Res 2014;51:577-585.
Hurlbert DF, Apt C, White LC: An empirical examination into the sexuality of women with borderline personality disorder. J Sex Marital Ther 1992;18:231-242.
Bornstein RF: Active dependency. J Nerv Ment Dis 1995;183:64-77.
Mussweiler T, Förster J: The sex- aggression link: a perception-behavior dissociation. J Pers Soc Psychol 2002;79:507-520.
Bouchard S, Godbout N, Sabourin S: Sexual attitudes and activities in women with borderline personality disorder involved in romantic relationships. J Sex Marital Ther 2009;35:106-121.
Impett EA, Peplau LA: Sexual compliance: gender, motivational, and relationship perspectives. J Sex Res 2003;40:87-100.
Johnson S, Zuccarini D: Integrating sex and attachment in emotionally focused couple therapy. J Marital Fam Ther 2010;36:431-445.
Kiefer AK, Sanchez DT: Scripting sexual passivity: a gender role perspective. Pers Relatsh 2007;14:269-290.
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