The chain mediating role of social support and anxiety between intimacy and self-efficacy in patients with psychogenic erectile dysfunction.

BACKGROUND

Psychogenic erectile dysfunction (pED) is closely associated with psychological factors such as anxiety and interpersonal distress. Psychological interventions aimed at enhancing self-efficacy in patients with pED can effectively improve erectile function and overall quality of life. This study examines the potential mediating associations of social support and anxiety in the relationship between intimate relationship quality and self-efficacy among patients with pED, providing theoretical guidance for intervention development.

METHODS

This study was a cross-sectional study conducted at a single tertiary hospital. A total of 210 patients with pED who were treated at the Andrology Outpatient Clinic of a tertiary Grade-A hospital in Nanjing from April 2024 to March 2025 were selected as the study subjects. Tools included the International Index of Erectile Function-5 (IIEF-5), the Quality of Relationship Inventory (QRI), the Social Support Rating Scale (SSRS), the Generalized Anxiety Disorder-7 scale (GAD-7), and the General Self-Efficacy Scale (GSES). Structural equation modeling (SEM) with Bootstrap analysis was utilized to explore the relationships among these variables.

RESULTS

The mean scores for intimate relationships, social support, anxiety, and self-efficacy were 32.28±7.88, 34.73±6.28, 6.79±4.92, and 23.72±5.33, respectively. Intimate relationships were significantly and positively correlated with social support (r=0.336, P<0.01) and self-efficacy (r=0.260, P<0.01), while showing a significant negative correlation with anxiety (r=-0.313, P<0.01). SEM analysis further indicated potential mediation effects of social support and anxiety on the relationship between intimate relationships and self-efficacy. The total indirect effect accounted for 51.52% (effect size: 0.321) of the total effect. Specifically, the indirect effects mediated through social support, anxiety, and the serial pathway accounted for 24.56%, 18.30%, and 8.51% of the total effect, respectively.

CONCLUSIONS

Intimate relationship quality demonstrated both direct and indirect associations with self-efficacy in patients with pED, mediated by social support and anxiety. Consequently, psychological interventions targeting the enhancement of relationship quality, the utilization of social support, and the alleviation of anxiety may help improve self-efficacy in this population.