INFIDELITY IN COMMITTED RELATIONSHIPS II: A SUBSTANTIVE REVIEW
Blow, Adrian J
This article, a follow-up on our methodological review of infidelity studies, provides a substantive review of the research findings on infidelity in committed relationships. The aim of this article is to present the most conclusive findings available to both researcher and practitioner on the subject of infidelity. We highlight attitudes toward infidelity; prevalence data; types of infidelity; gender dynamics and infidelity; issues in the primary relationship and their relationship to infidelity; race, culture, and infidelity; education, income, employment, and infidelity; justifications for infidelity; individual issues and their relationship to infidelity; same-sex couples and infidelity; attachment and infidelity; opportunity and infidelity; the aftermath and recovery process from infidelity; and clinical practices.
Infidelity is a subject that confronts couple therapists regularly in their clinical practices. It can be a confusing and heart-wrenching experience for all involved, including the therapist who may have his or her own personal fears and values related to infidelity. Couple therapists who stay abreast of current research literature may find themselves frustrated when they attempt to assimilate the research findings on infidelity. There are limitations in methodologies, conflicting results, and information that is of little practical value in the therapy room.
This article, the second of two on the subject of infidelity in committed relationships, has one main purpose-to bring readers up to date on what the research says about the subject. In our review of the literature, we found that there are many different opinions, ideas, and points of view related to infidelity. For the purpose of this article, however, we will focus specifically on the available empirical research data and will avoid describing interesting opinions, theoretical ideas, or conjectures that are not rooted in research evidence of some kind. As a result, the data we review in this article come directly from the list of articles we included in article I (this issue), in which we evaluated the methodology of every infidelity-related study we could find published in journals in the fields of couple and family therapy, sex therapy, family studies, and related disciplines (see Blow & Hartnett, this issue, for the list of articles and their specific inclusion criteria).
The data presented in this substantive review must be interpreted in light of the critique of research methodologies we presented in the companion article. The research on infidelity is extremely complex; there are interactional effects among study variables, and, as a result, the phenomenon is not easily understood in a simplistic or linear fashion. Further, practitioners must exercise caution in using this information as they work with couples and individuals, as these research findings are not absolute truths; rather, they are tentative ideas about what might be going on in the lives of clients. It is important to note that even though we review the broad subject of infidelity, studies use the term differently and apply it to diverse types of relationships (see our companion article for an extensive discussion of definitional issues in infidelity research).
Although other literature reviews exist on infidelity (Atkins, Dimidjian, & Jacobson, 2001; Glass & Wright, 1988, 1997; Thompson, 1983), we believe that our appraisal is different in that it describes all of the most recent infidelity research in one comprehensive article. Further, as we explored the infidelity literature, we were particularly mindful of the methodological issues we presented in Blow and Hartnett (this issue). Therefore, we hope that our substantive review presents a balanced look at what researchers have added to our understanding of infidelity to date. Note that we do not list every finding from every study; instead, we summarize major research findings using studies as examples.
Attitudes Toward Infidelity
Attitudes toward infidelity are important in that some research suggests that individuals with more permissive attitudes toward infidelity in relationships are more likely to engage in infidelity (Treas & Giesen, 2000). In the literature we reviewed, we found that several researchers captured their participants’ general views, attitudes, and opinions about infidelity. For example, in their large study using a representative United States sample, Laumann, Gaugnon, Michael, and Michaels (1994) found that 77% of their participants believed that extramarital (EM)1 sex was always wrong. It appears that such disapproval may stem from a general belief that infidelity is immoral (Blumstein & Schwartz, 1983; Prins, Buunk, & VanYperen, 1993).
Weis and Jurich (1985) used stepwise regression analyses to explore several factors that influence individuals’ attitudes toward EM sex. In this large-sample study, they found that people who are well educated, who are from large metropolitan areas, who have permissive attitudes about premarital sex, and who are either single or dissatisfied with their marital relationship, are relatively more accepting of EM relationships. Interestingly, they found that size of community was a significant direct predictor of EM attitudes-even more so than marital satisfaction or status. In their analysis, those who frequently attended church were also more likely to disapprove of EM sex. Given some of the difficulties with stepwise regression-such as the fitting of data, decisions as to which variables to include and omit, and interpretations of final p-values-these findings should be interpreted with caution (Tabachnick & Fidell, 1996).
Attitudes toward infidelity appear to differ because of interaction effects with other variables. These variables include culture (Knodel, Low, Saengtienchai, & Lucas, 1997; Solstad & Mucic, 1999; Widmer, Treas, & Newcomb, 1998); gender (Glass & Wright, 1985); type of primary relationship (e.g., heterosexual, lesbian, dating, marriage [Blumstein & Schwartz, 1983]); the behaviors that make up the infidelity (e.g., oral sex, kissing, sexual intercourse, love connection [Blumstein & Schwartz, 1983]); and prior experience with infidelity (Solstad & Mucic, 1999; Thompson, 1984; Wiederman, 1997).
Regarding culture, Widmer et al. (1998) sampled 33,590 individuals from 24 countries and found strong disapproval of EM sexual relationships, although several countries (e.g., Russia, Bulgaria, Czech Republic) appeared to be more tolerant than others. In a sample of mostly married or cohabiting individuals in the Netherlands, both men and women disapproved of infidelity in relationships on moral grounds (Prins et al., 1993). In a Danish sample, Solstad and Mucic (1999) found that participants had permissive attitudes toward infidelity, and those who engaged in an infidelity relationship were more accepting of infidelity. The authors attribute these findings to the overall liberal values of Danish society (Solstad & Mucic, 1999).
Glass and Wright (1992) found an interaction between gender and attitudes toward infidelity. In their particular sample (commuter, middle-to-upper-class, Caucasian), men made greater distinctions between sex and love than did women. Men were more likely to see EM sexual involvement as only sexual (i.e., no emotional involvement), whereas women were more likely to combine sexual and emotional involvements. For men, in particular, there was an association between their attitudes toward infidelity and their actual behaviors (i.e., an association between approval of infidelity involvement and actual involvement [note, this does not denote causality]). In a Thai sample, a qualitative study by Knodel et al. (1997) found that study participants viewed women as having “weaker” and less urgent desires for sexuality, whereas men were seen to have a natural need for sex that requires frequent satisfaction. Women, when they had sexual urges, were viewed as being able to control them, in contrast to “out of control” men. Further, the participants agreed that it was far more morally wrong for women to engage in marital infidelity than it was for men. For men, attitudes toward EM sexuality shifted depending on the type and circumstances of the infidelity relationship. An important criterion was that family needs were not neglected. Lieberman (1998) studied infidelity in premarital relationships and concluded that women were more disapproving of sexual relations outside of the primary relationship than were men. Compared with men, women expressed greater disapproval of the statement, “Extrapremarital relations are just good fun” (Lieberman, 1988, p. 295). This study is limited because of its college sample.
In the large study conducted by Blumstein and Schwartz (1983), the results convincingly show that there are also different attitudes toward infidelity depending on the type of relationship. For example, their data show that gay men, compared with heterosexual couples, are not as concerned if their partners are nonmonogamous. Further, they conclude that there are different kinds of infidelity, and, depending on the relationship, some types are considered cheating and some are not. Other research also shows that attitudes toward infidelity vary depending on the type of infidelity in question. Studies show that participants disapproved of infidelity that involved sexual intercourse, disapproved less of emotional-only infidelity, and were most disapproving of relationships that involved both sexual activity and emotional connection (Glass & Wright, 1985; Thompson, 1984).
It appears that stances toward infidelity may also depend on one’s prior experiences (i.e., whether or not one has actually participated in infidelity or been a “victim” of infidelity in some way-either directly in one’s own relationship or indirectly through an experience in one’s family or friendship network). In Glass and Wright’s (1992) study, 90% of both husbands and wives who had engaged in infidelity felt there were definite conditions under which infidelity was justified. Other research concurs that people who have participated in infidelity are more approving of such relationships than those who have not (Solstad & Mucic, 1999; Thompson, 1984; Wiederman, 1997). Liu (2000), for example, notes that the men who are more likely to engage in infidelity in relationships are also the men who are more approving of infidelity. It can be asked, then, do such men approve of the infidelity more because they have engaged in more infidelity? Or, was this attitude present before they engaged in infidelity?
The Prevalence of Infidelity
Many research studies attempt to estimate exactly how many people engage in infidelity, and the statistics appear reliable when studies focus on sexual intercourse, deal with heterosexual couples, and draw from large, representative, national samples. From the 1994 General Social Survey of 884 men and 1288 women, 78% of men and 88% of women denied ever having EM sex (Wiederman, 1997). The 1991-1996 General Social Surveys report similar data; in those years 13% of respondents admitted to having had EM sex (Atkins, Baucom, & Jacobson, 2001). In the 1981 National Survey of Women, 10% of the overall sample had a secondary sex partner. Married women were the least likely (4%), dating women more likely (18%), and cohabiting women most likely (20%) to have had a secondary sex partner (Forste & Tanfer, 1996).
Studies on sexuality include infidelity data on both lifetime incidence and the immediate past (e.g., last year). This is the case because individuals may have difficulty remembering how many times infidelity occurred over the course of a lifetime, whereas they may have an easier time remembering the details of the immediate past (Wiederman, 2000). Further, comparing lifetime and immediate past data may help us to understand behavior trends over time. For example, Laumann et al. (1994) report that 25% of married men and 15% of married women admitted to having engaged in EM sex at least once. However, less than 4% of the sample reported EM sex in the previous year. This finding may indicate declining rates of infidelity in marriage, or it may reflect that different cohorts may engage in more infidelity than others. It also reflects the fact that much of sexual infidelity occurred more than 1 year in the past.
Compared with Laumann et al. (1994), other authors report significantly lower prevalence statistics. General Social Surveys conducted in 1988 and 1989 showed that a mere 1.5% of married people reported having had a sexual partner other than their spouse in the year before the survey (Smith, 1991), and less than 3% of Choi, Catania, and Dolcini’s (1994) sample had engaged in EM sex in the previous 12 months. In a 1993 probability sample that included 1194 married adults, 1.2% had EM sex in the last 30 days, 3.6% had EM sex in the last year, and 6.4% had EM sex in the last 5 years (Leigh, Temple, & Trocki, 1993). These results possibly indicate that the number of EM sexual involvements in any given year is quite low, but that over the lifetime of a relationship this number is notably higher.
In general, based on the above data, we can conclude that over the course of married, heterosexual relationships in the United States, EM sex occurs in less than 25% of committed relationships, and more men than women appear to be engaging in infidelity (Laumann et al., 1994; Wiederman, 1997). Further, these rates are significantly lower in any given year. From studies of other countries, it appears that rates of infidelity are higher or lower in some places and that gender differences vary considerably (e.g., Knodel et al., 1997; Pulerwitz, Izazola-Licea, & Gortmaker, 2001; Solstad & Mucic, 1999).
It is important to note that prevalence data vary greatly in studies with broader definitions and populations of interest. We propose, therefore, that future surveys collect data from large samples of people involved in dating, cohabiting, and marriage relationships, as well as from divorced individuals whose relationships may have dissolved because of infidelity (Christopher & Sprecher, 2000). Further, it is critically important that data are not simply collected in terms of sexual intercourse. Research that limits the definition of infidelity to sexual intercourse minimizes the devastating effects that other types of sexual involvement and emotional connections can have on relationships. Finally, gathering prevalence data from diverse individuals in terms of ethnicity, socioeconomic status, sexual orientation, and employment types may yield striking differences between groups.
Types of Infidelity
Both the clinical and self-help literature reference general types of infidelity, including one-night stands, emotional connections, long-term relationships, and philandering (Brown, 2001; Pittman, 1989). However, most of the empirical literature does not delineate these types of infidelity, nor does it offer ideas on how prevalent different types of infidelity are or in what kinds of relationships they exist. Further, the specific behaviors associated with infidelity are under-researched; those studies that have attempted to determine what actually occurs in infidelity in relationships have focused primarily on sexual intercourse (see Appendix in Blow & Hartnett, this issue).
There is evidence that there are emotional-only, sexual-only, and combined sexual and emotional types of infidelity (Glass & Wright, 1985; Thompson, 1984). These categories are not necessarily mutually exclusive, and Glass and Wright (1985) explore infidelity on a continuum of sexual involvement and emotional involvement. Further, within each general category there are different types. For example, emotional infidelity could consist of an internet relationship, a work relationship, or a long-distance phone relationship. Sexual infidelity could consist of visits with sex workers, same-sex encounters, and different types of sexual activities. In short, carefully conducted studies are needed to test accurately the hypotheses related to types of infidelity and to determine their prevalence in the general population and in specific subpopulations.
Gender Differences in Infidelity
Atkins, Baucom, and Jacobson (2001) report that gender is the variable that has been studied most often in relation to infidelity. One might expect, therefore, that it would be relatively simple to determine if men or women are more prone to engage in infidelity. However, in attempting to answer such a question, especially when the focus moves away from sexual intercourse, the body of infidelity literature offers no more clear answer than “it depends.” This is largely due to interaction effects between gender, infidelity, and other important variables such as age, relationship type, and infidelity type.
Some authors strongly assert that more men (when compared with women) engage in infidelity (Alien & Baucom, 2004; Atkins, Baucom, & Jacobson, 2001), have significantly more sexual partners outside of their primary relationship (Blumstein & Schwartz, 1983; Spanier & Margolis, 1983; Wiggins & Lederer, 1984), have more permissive attitudes toward sex outside of the primary relationship (Lieberman, 1988; Thompson, 1984), and have a stronger desire to engage in infidelity (Prins et al., 1993). In a recent study, Allen and Baucom (2004) found that men with dismissive attachment styles are particularly prone to engage in infidelity.
At the same time, other research suggests that men are only “somewhat” more likely than women to engage in infidelity (Choi et al., 1994), that men and women’s rates of infidelity are becoming increasingly similar (Oliver & Hyde, 1993), and that men and women really do not differ in terms of behavior (even though men desire it more; Prins et al., 1993). Wiederman (1997) supports this notion; he found that there are no differences in frequency and types of infidelity for men and women under the age of 40.
Gender appears to interact with types of infidelity and the meanings attached to the behavior (Glass & Wright, 1985, 1992). For example, for women there generally appears to be a greater emphasis on emotional connection than for men, whereas for men, there generally seems to be a greater emphasis on sexual experience. A study that also looked at combined-type affairs (i.e., those with a both a sexual and emotional connection [Spanier & Margolis, 1983]) supports the notion that emotional experience in infidelity is more important to women than it is to men. Incidentally, it appears that women are more inclined to engage in these combined-type infidelities (Glass & Wright, 1985).
Regarding sexual type infidelity, it seems that men tend to have more physically intense experiences than do women (Glass & Wright, 1985); that is, although women might be inclined to hug or kiss a partner in an infidelity situation, men may have significantly greater physical contact, including intercourse. In contrast, women engaged in emotional infidelity tend to have a higher degree of emotional connection than do men engaged in emotional infidelity (Glass & Wright, 1985); women are more likely to fall in love with the partner with whom they engage in infidelity, whereas men may consider such partners as close friends. This research needs to be further explored in future studies given the limitations of the sample (commuter, middle-to-upper-class, Caucasian) of the Glass and Wright studies (1985, 1992).
It also appears that rates of infidelity between genders differ depending on the type of relationship. For instance, in a study of dating relationships, significantly more men than women engaged in sexual activities outside of their primary relationship (Hansen, 1987). Blumstein and Schwartz (1983) report that in same-sex couples, lesbians have fewer outside partners, whereas gay men have more partners and seek more variety. For all types of couples, possessiveness seems to increase when one partner fears that the other might have a meaningful affair (i.e., there is a degree of emotional/love involvement [Blumstein & Schwartz, 1983; Worth, Reid, & McMillan, 2002]).
Finally, some studies reported interactions between gender and age in regard to infidelity (Atkins, Baucom, & Jacobson, 2001; Wiederman, 1997). Atkins, Baucom, and Jacobson (2001) found that in their sample, women ages 40-45 and men ages 55-65 were more likely to report having had EM sex at some point in their lifetime. Individuals outside of these age ranges were less likely to have engaged in EM sex, and men and women younger than age 45 (under 40, according to Wiederman, 1997) did not differ significantly in their reported rates of EM sex. It is important to note that these data may not necessarily be reflective of age, but rather of cohort values. In other words, because of the cross-sectional nature of these studies, there is no way to separate out cohort effects from developmental effects (Atkins, Baucom, & Jacobson, 2001).
Issues in the Primary Relationship and their Connections to Infidelity
Primary relationship status. The results of some studies suggest that marriage deters individuals from engaging in infidelity. Married women are less likely to engage in infidelity than are cohabiting or dating women, whereas cohabiting and dating women are equally likely to have a secondary sex partner (Forste & Tanfer, 1996). Treas and Giesen (2000) also report that married women are less likely than cohabiting women to engage in infidelity, and they add that once cohabiting women get married, they are more similar to married women who never cohabited in terms of their expectations for sexual exclusivity. It appears, then, that there is a commitment mechanism in marriage that may serve as a protective factor against infidelity for some couples. We found no data on levels of commitment and infidelity, but we speculate that marriage’s protective factor might be more closely related to the level of commitment in the relationship, rather than to the marriage institution, per se.
Primary relationship satisfaction. Some studies support the idea that individuals engage in infidelity because there is something wrong in their primary relationship (i.e., as marital happiness or satisfaction decreases, the occurrence of EM sex increases [Atkins, Baucom, & Jacobson, 2001; Glass & Wright, 1985]). At the very least, suggest Prins et al. (1993), dissatisfaction in the primary relationship increases the desire for EM involvement. Glass and Wright (1985) found the negative correlation between marital satisfaction and infidelity to be true for all types of EM involvement (sexual, emotional, and combined sex and emotion), although they discovered that relationship dissatisfaction is particularly related to emotional infidelity. Further, men and women who are involved in both sexual and emotional infidelities are even more dissatisfied with their marriages than are those engaged in either sexual-only or emotional-only infidelities (Glass & Wright, 1985).
The relationship between infidelity and relationship satisfaction may be particularly important for women. In general, women who are dissatisfied with their spouse or marriage engage in more frequent EM relationships than women who are satisfied (Prins et al., 1993; Wiggins & Lederer, 1984). Further, among those who engage in EM sex, women are significantly less satisfied in their marriages than are men (Glass & Wright, 1985).
Wiggins and Lederer (1984) found an interesting relationship between primary relationship satisfaction and the venue in which infidelity occurs. In their small, clinical sample, the men and women who admitted to having EM relationships with coworkers reported significantly higher marital satisfaction than people having relationships with non-coworkers. In other words, their study suggests that people who engage in infidelity with coworkers are not necessarily unhappy in their primary relationships; rather, they are acting on the opportunity available to them. Spanier and Margolis (1983) also report that the connection between marital satisfaction and infidelity may not be so simple. Although they found that 70% of their participants who engaged in infidelity attributed their behavior to marital problems, they also found no significant relationship between marital satisfaction and the occurrence of infidelity in “the months directly preceding separation” (p. 44). Spanier and Margolis (1983) conclude that “respondents’ EM sexual relations had little effect on their perceptions of marital quality compared to respondents who did not engage in [EM coitus]” (p. 44). This conclusion is questionable because of the retrospective nature of the data.
It is also likely that there are mediating variables that determine the correlation between relationship satisfaction and infidelity. For example, Atkins, Baucom, and Jacobson (2001) report that marital happiness does not act as an independent predictor of infidelity; instead, their data suggest that couples’ religious behavior interacts with marital satisfaction to affect the likelihood of infidelity. Likewise, Thompson (1983) estimated that the characteristics of the primary relationships accounted for only 25% of the variance in infidelity. Based on inconsistent results across studies, it appears that relationship satisfaction is an important predictor of infidelity only for some couples, and there are likely interactional effects with other variables for all couples. For example, a one-night stand for a spouse who travels for 3 weeks out of every month may not necessarily be in reaction to a troubled relationship at home, but a deep, nonsexual, emotional connection might reflect high levels of dissatisfaction in the primary relationship.
It must be remembered that across studies, relationship satisfaction is inconsistently defined and measured. For example, some studies use the Locke-Wallace Marital Adjustment Test (Locke & Wallace, 1959) to measure this variable, whereas others ask only one question. The retrospective nature of infidelity research presents another major challenge in attempting to ascertain the connection between relationship satisfaction and infidelity; that is, in most studies, research participants are asked questions about their primary relationship satisfaction after infidelity has already occurred.
Sexual satisfaction in the primary relationship. Although some researchers may disagree (e.g., Wiggins & Lederer, 1984), most research suggests that sexual satisfaction in the primary relationship may play a part in individuals’ inclination toward infidelity. For example, Liu (2000), who used National Health and Social Life Survey data to test a theoretical model of marital sexual life, concluded that the decline in frequency of sexual activity in a marriage leads to a higher incidence of infidelity, especially for men. Liu further suggests that the quality of the sexual relationship in the marriage could also influence infidelity.
In a large study that focused on sexual infidelity and HIV risk, Choi et al. (1994) found that race plays a part in the relationship between sexual satisfaction and infidelity. Although they found no association between those variables for White participants, “African Americans who reported sexual problems and Hispanic men with poor sexual communication skills were more likely to report [sexual infidelity]” (Choi et al., 1994, p. 2005). Race may not be the only interactional variable between sexual satisfaction and infidelity; gender appears to play a part as well. For instance, Liu (2000) found that the negative relationship between sexual satisfaction and infidelity is stronger for men, whereas Prins et al. (1993) found the correlation stronger for women. However, Prins et al. found no difference between men and women in terms of how sexual satisfaction influenced the desire to engage in infidelity.
Length of the primary relationship. For women, longer primary relationships seem to have a greater correlation with infidelity than do shorter relationships (Forste & Tanfer, 1996). According to Forste and Tanfer (1996), this finding holds true for dating women, cohabiting women, and married women; Hansen (1987) did not find this correlation with dating women. For married women overall, their rates of likelihood of EM involvement reach a peak in the seventh year of marriage and decline steadily thereafter (Liu, 2000). For married men, in contrast, longer relationships correlate with a decreased likelihood of infidelity, but reach a critical point in the eighteenth year of marriage, at which time the chance that men will have an infidelity begins to increase (Liu, 2000). For men in dating relationships, the longer they have been dating someone, the greater the chance that they will engage in sexual activities with someone else (Hansen, 1987). This may have something to do with the level of commitment in the dating relationship. Treas and Giesen (2000) found no correlation between relational length and infidelity whatsoever. Note that all of these studies are cross-sectional, which puts into question the validity of their findings.
Presence and number of children in the primary relationship. It is thought that having children together increases partners’ sense of investment in their relationship (Belsky, 1990), and Liu (2000) theorizes that having children acts as a deterrent against infidelity. In contrast, many studies report that children decrease the relational and sexual satisfaction of some couples due to increased demands, stress, and commitments (Gottman & Notarius, 2000). Given the negative correlation between relationship satisfaction and infidelity reported in certain studies, some couples with children may actually be more vulnerable to infidelity. Unfortunately, research says very little on this subject, and most studies do not take into consideration or even report the number of children in relationships. Future research should consider both the number of children in a primary relationship as well as specific child characteristics and parent-child dynamics. Potentially telling areas of investigation include ages of the children (teenager vs. toddler vs. infant), stepchildren, adopted children versus biological children, children with disabilities, and the like. Researchers have likewise offered very little information on other, specific life Stressors that might affect a relationship and increase the likelihood of infidelity, such as spousal illness or injury.
Religious Affiliation, Religiosity, and Infidelity
Although some research indicates no relationship between attendance at religious services and infidelity (e.g., Blumstein & Schwartz, 1983), other studies suggest that attendance at religious services leads to lower rates of infidelity for some groups of people (Amato & Rogers, 1997; Atkins, Baucom, & Jacobson, 2001; Forste & Tanfer, 1996; Treas & Giesen, 2000). Hansen (1987) reports that for women (and not for men), religious activity correlates negatively with infidelity, whereas Liu (2000) reports that such a correlation exists only for men and not for women. Choi et al. (1994) found a similar negative correlation between church attendance and infidelity, although they discovered that the relationship was significant only for Black and Hispanic participants and not for White participants. Spanier and Margolis (1983) found a strong association between religiosity and the number of years after marriage that couples first experienced EM sex. Forste and Tanfer (1996) found that cohabiting and dating couples who do not share similar religious values are more likely to experience infidelity.
We speculate that religious behavior may have an effect on the likelihood of engaging in infidelity through its influence on relationship happiness (Atkins, Baucom, & Jacobson, 2001) and through individuals being continually exposed to messages condemning EM involvement (Liu, 2000). It is also possible that some of those who attend religious services have tighter social networks, and this exposure helps people to adhere to the norms of the community (Liu, 2000).
We want to emphasize at this point that the definition of religiosity is fraught with its own complex problems, and its operationalization varies depending on who is doing the research. Most studies measure religiosity in terms of attendance at religious services, with higher attendance rates meaning that an individual is more religious and connected to a religious community (Atkins, Baucom, & Jacobson, 2001; Liu, 2000; Treas & Giesen, 2000). Spanier and Margolis (1983) asked respondents if they considered themselves to be religious or not on a 4-point scale ranging from very religious to not at all religious. In the Amato and Previti (2003) study, religiosity was based on how much religious beliefs influenced an individual’s life. Religiosity certainly appears to influence the decision to engage in infidelity, and it no doubt has an impact on how couples and individuals heal from their wounds. However, the research does not expound on how these processes occur and for which religious groups. Further, definitions of religiosity that take into account spirituality, for example, might yield different results. This variable is multifaceted and worthy of future exploration.
Race, Culture, and Infidelity
Some researchers report a positive correlation between being African American and engaging in infidelity (Amato & Rogers, 1997; Smith, 1991). However, even in studies that were intentional about gathering representative samples, the correlation between race and infidelity is unclear. For example, Choi et al. (1994) showed no significant difference between White and Hispanic or African American involvement in infidelity and maintained that low-to-moderate educational level is a mediating variable between race and infidelity. However, in another study that oversampled Hispanics and African Americans, Treas and Giesen (2000) reported that African Americans are more likely to engage in infidelity-even with educational attainment controlled.
Wiederman’s (1997) data suggest that race and infidelity are correlated, but only in regard to infidelity that occurred in the last year. In other words, African Americans and Whites do not differ in terms of lifetime incidence of infidelity. Wiederman (1997) speculates that this may be due to ethnic differences in the gender ratio, with the shortage of single men in the black community leading to an increase in opportunities for married black men to engage in infidelity with single black women.
Race also appears to interact with gender in relation to infidelity. For instance, Choi et al. (1994) found that, among African Americans, men are more likely to engage in sexual infidelity than are women. They did not find a correlation between gender and sexual infidelity among their White research participants.
In summary, the data on race and infidelity are mixed, at best. It seems that some studies conclude that infidelity is higher among African American men in particular, whereas other studies show no differences between ethnic groups. We acknowledge that smaller studies that explore the intricacies of infidelity are generally limited to homogenous, Caucasian samples, and that limits our understanding of how infidelity plays out in different cultural groups. Differences in cultures are clearly indicated in the few international studies available (Buunk, 1987; Knodel et al., 1997; Solstad & Mucic, 1999), and more concerted efforts to explore the experiences of specific ethnic groups are needed.
Education Levels and Infidelity
Studies differ in their analyses of the correlation between education and infidelity. Using a national data set, Atkins, Baucom, and Jacobson (2001) conclude that highly educated people are more likely to report having engaged in EM sex. More specifically, “participants with graduate degrees were 1.75 times more likely to have had [EM sex] than participants with less than a high school education” (p. 743). They conclude that there is a significant interaction effect between divorce and education levels and that the relationship between education and infidelity is only true for individuals who are divorced.
In a large, national study of married, cohabitating, and dating women, Forste and Tanfer (1996) found that education is a significant correlate of infidelity for married women, but only to the degree that her and her partner’s educational levels differ. More specifically, they suggest that if a woman has more education than her partner, she is more likely to have a sexual relationship outside of her primary relationship; if her husband has more education, she is less likely to engage in infidelity. For dating and cohabiting women, there is a direct, positive relationship between educational level and infidelity; these researchers suggest that higher education may be associated with more liberal attitudes towards sexuality.
Collectively, the data from these studies are quite interesting. We have heard people state that highly educated individuals are more likely to engage in infidelity. However, it appears that assertion is not a categorical truth, but rather a factor that may depend on the educational dynamics of partners in the relationship and history of divorce. Further research is needed in this regard.
Income Levels, Employment, and Infidelity
Income and EM sex seem to have a positive relationship. Atkins, Baucom, and Jacobson (2001) found that individuals who earned more than $30,000 annually were more likely to engage in infidelity than individuals who earned less. These researchers suggest that it may not be the money, per se, that leads to infidelity, but instead factors such as stress levels, education, entitlement, and opportunity. Further, the risks of engaging in infidelity might be too great for individuals who are financially dependent on their partners. Also, as seems to be the case with education, the distribution of income between partners appears to influence the likelihood of infidelity. For example, when spouses are both unemployed, the incidence of EM sex is lower than it is when one partner works (Atkins, Baucom, & Jacobson, 2001).
In a more general sense, it appears that employment has significantly influenced infidelity over the years. The work environment provides a host of potential partners, and individuals frequently find themselves spending a great deal of time with these individuals (Treas & Giesen, 2000). Further, greater access to financial resources potentially brings an increased sense of entitlement, as well as more opportunities to meet possible partners. Much more research is needed on the relationship between work, the type of work, and infidelity. Work possibly influences different genders in different ways.
Individual Characteristics and Infidelity
Interest in sex and prior sexual experience. Some evidence suggests that people with a strong interest in sex are more likely to engage in sex outside their primary relationship (Liu, 2000; Treas & Giesen, 2000). Prior sexual experiences (defined in one study as the number of sexual partners between age 18 and start of first marriage or cohabitation) are positively associated with infidelity (Treas & Giesen, 2000), and married and dating women with four or more sexual partners prior to their primary relationship are more likely than other women to engage in infidelity (Forste & Tanfer, 1996).
For women in dating relationships, having a liberal sexual attitude offered the best prediction that they would engage in sexual activity outside their primary relationship; such a correlation did not hold true for men in dating relationships (Hansen, 1987). Likewise, in a study that examined decisions to end an EM relationship, women with positive attitudes toward sex were not only more likely to start an infidelity, but they also remained longer in these relationships than did women with negative attitudes (Hurlbert, 1992). Given the sample used (female, assertiveness-training workshop participants who were mostly Caucasian), data from this study should be interpreted with caution.
Other potentially important considerations. It appears that parental divorce generally increases the odds of engaging in infidelity (Amato & Rogers, 1997). However, there are no findings on the influence of parental infidelities on the likelihood of their children engaging in infidelity. The risk of contracting or spreading AIDS does not seem to influence actual and desired infidelity (Prins et al., 1993), and Choi et al. (1994) found that fewer than one-half of individuals reporting sex outside of the primary relationship either occasionally or always use condoms with their primary and secondary sex partners. This was supported in the Pulerwitz et al. (2001) study conducted in Mexico City. Sexual relationships outside of the primary relationship correlate positively with nontraditional gender-role orientation for women (Hansen, 1987). Past divorce (Atkins, Baucom, & Jacobson, 2001) and remarriage (Christopher & Sprecher, 2000) appear to influence strongly the likelihood of having an affair. Lifetime rates of infidelity are twice as high among men and women who have been divorced or legally separated (Wiederman, 1997).
The age at which couples begin a relationship may also suggest a vulnerability point. It appears that the younger people are when they begin a relationship, the more likely they are to experience infidelity in that relationship (Amato & Rogers, 1997; Atkins, Baucom, & Jacobson, 2001). It is important to consider how researchers define young. For example, the Atkins et al. study defines young as 16 years of age or younger. Although Wiggins and Lederer (1984) found no correlation between age at marriage and number of liaisons, they found that those people with the largest number of infidelities seem to have begun engaging in infidelity earlier in their relationships.
Same Sex Couples and Infidelity
Limited research exists on same-sex couples, outside of the large Blumstein and Schwartz (1983) study. Nonmonogamous lesbians are less satisfied with the sex in their primary relationship and are less committed to a future together (Blumstein & Schwartz, 1983). This finding should be interpreted with caution given the date of this study. Some gay, male relationships appear to adapt well to sexual experiences outside of the primary relationship, but this appears to influence the sexual satisfaction between partners in the primary relationship negatively (Blumstein & Schwartz, 1983). In a qualitative study, Worth et al. (2002) concluded that even though sex outside a gay relationship might be more acceptable in some gay relationships, it does not occur without pain and jealousy.
Attachment and Infidelity
Given the burgeoning research on attachment in committed relationships and its links to relationship satisfaction (Brennan & Shaver, 1995) and treatment of couples (Johnson, 1996, 2002), we were surprised to find only two studies linking infidelity to attachment. In a sample of 792 young adults, Bogaert and Sadava (2002) concluded that people who scored higher on an anxious attachment index were more likely to engage in infidelity. This was especially true for women.
Allen and Baucom (2004) used a sampling method similar to Glass and Wright (1985, 1992) to explore adult attachment and patterns of extra-dyadic involvement. Their sample consisted of 345 (504 total sample) undergraduate students as well as 115 (250 total sample) community adults who reported prior extra-dyadic involvement. In the undergraduate sample, men with a dismissive attachment style and women with a preoccupied attachment style had the largest number of partners outside of their primary relationship. In the community sample, the data show that participants with dismissive attachment styles were more likely to engage in infidelity, although there was not a significant effect in this regard.
Attachment style and motivations for infidelity may also be related (Allen & Baucom, 2004). For example, in this study, participants with fearful and preoccupied attachment styles reported more intimacy motivations for infidelity. In the undergraduate sample only, these styles were also related to self-esteem motivations, especially for preoccupied attachment-style women and fearful attachment-style males. In both undergraduate and community samples, dismissive attachment styles were more likely than other styles to indicate the rationale for infidelity as a need for autonomy from the primary relationship (i.e., space and freedom).
Regarding types of infidelity relationships, Allen and Baucom (2004) show that both male and female undergraduate participants, as well as men only in the community sample, were more likely to engage in an obsessive and needy infidelity relationship if they had a fearful or preoccupied style of attachment (as opposed to a secure or dismissive style). Further, in both samples, participants with fearful attachment styles were more likely to feel ambivalent about intimacy in the extra-dyadic relationship. Allen and Baucom (2004) conclude that there is support for “the hypothesis that attachment style is related to intimacy regulating functions of EDI [extra-dyadic involvement]” (p. 482). Based on this study, it seems likely that therapists may bolster their clinical work by matching specific interventions with the attachment styles of those who have engaged in infidelity.
Opportunity and Infidelity
Opportunity is a difficult variable to understand across studies because authors operationalize it differently. Atkins, Baucom, and Jacobson (2001) measured opportunity by considering employment status and income, and they found a positive relationship between infidelity sex and opportunity. Liu (2000) found this to be true for men only. Wiggins and Lederer (1984) found that opportunities in the workplace, specifically, are significantly related to infidelity; nearly one-half of their sample who engaged in infidelity were involved with coworkers. Almost two decades later, Treas and Giesen (2000) found similar results: “Sexual opportunities in the workplace . . . increased the likelihood of infidelity during the last 12 months” (p. 59). Despite these findings, it may be that some workplaces actually serve as deterrents against infidelity because of their strong admonitions against such activity (e.g., military settings).
Although it appears that workplace opportunity might be a significant contributor to the likelihood of infidelity, non-workplace opportunities do not appear to be important factors. For example, Wiederman (1997) found that for both men and women, size of community and incidence of infidelity are unrelated. Although Treas and Giesen (2000) did find a correlation between living in a large city and engaging in infidelity, “any effect of city residence was substantially reduced when ‘cosmopolitan’ sexual values and tastes were controlled” (p. 59). Again, this must be interpreted cautiously because of the qualities of some individuals who choose to live in city environments. Smith (1991) found only a weak relationship between living in a large suburb and engaging in infidelity, and he discovered that infidelity does not vary by region of the country. Finally, couples who live “separate” lives have more opportunity to be nonmonogamous, and they seem to act on those opportunities (Blumstein & Schwartz, 1983). More data are needed on opportunities that exist outside of the workplace and on what specific aspects of living separate lives lead to increased rates of infidelity.
The findings about perceived and actual opportunity leading to a higher incidence of infidelity have important implications for clinical work and recovery. In treatment, it seems that therapists would do well to encourage partners to contain the opportunities for infidelity so that the primary relationship can be the focus (Glass & Wright, 1988). It appears in some cases that opportunity can override the positive aspects of a relationship, and even strong relationships can experience infidelity if the right opportunities come along. Even though research is not conclusive on this point, Glass (2002) convincingly argued that people in good marriages are vulnerable to emotional and sexual infidelity. Blumstein and Schwartz (1983) agree that all couples are vulnerable to infidelity.
Justifications for Engaging in Infidelity
Glass and Wright (1992) focused specifically on the justifications for infidelity, and they found that individuals defend their EM relationships in several ways. Rationalizations along the sexual dimension included sexual enjoyment, curiosity, and excitement, whereas justifications in the emotional dimension included intellectual sharing, understanding, companionship, and ego-bolstering aspects of self-esteem. Two additional factors for both men and women are an extrinsic motivation dimension, which includes career advancement and getting even with a spouse, and a love dimension, which includes getting love and affection and falling in love (Glass & Wright, 1992).
According to Glass and Wright (1992), men tend to justify infidelity via the sexual dimension, whereas emotion-related rationalizations were the second most frequently mentioned. For women, the order of the two dimensions was reversed, as might be expected given the findings presented earlier in this article. In their study on attachment styles and infidelity, Alien and Baucom (2004) report similar emotion-based justifications for women. Specifically, they found that women seem to be motivated to engage in infidelity when they desire closeness or when they sense neglect or rejection in their primary relationship.
The Aftermath of Infidelity
Some studies suggest that only a small percentage of couples who experience infidelity actually improve their primary relationship (Charny & Parnass, 1995; Hansen, 1987). Still, not all couples who experience infidelity end their relationships (Buunk, 1987; Charny & Parnass, 1995), and some studies suggest that couples who experience infidelity can have surprisingly positive relationship outcomes. For example, Olson, Russell, Higgins-Kessler, and Miller (2002) conducted a qualitative study and found that there are some unintended positive outcomes of infidelity for couples, including closer marital relationships, increased assertiveness, placing higher value on family, taking better care of oneself, and realizing the importance of good marital communication. Atkins, Eldridge, Baucom, and Christiansen (2005) found that couples who were in therapy and openly dealing with infidelity changed at a comparable or faster rate than other distressed couples who were in therapy.
In terms of negative consequences, Charny and Parnass (1995) remark that betrayed partners’ reactions have included rage, loss of trust, decreased personal and sexual confidence, damaged self-esteem, fear of abandonment, and a “surge of justification to leave the spouse” (p. 107). Likewise, an overwhelming majority of the participants in the Schneider, Irons, and Corley (1999) study noted that they had experienced adverse consequences as a result of disclosing infidelity. This study was comprised of persons and their partners who had been diagnosed as having a sexual addiction or compulsive sexual disorder. Twenty-five percent of those who had engaged in infidelity and nearly 60% of their primary relationship partners said that they suffered emotional problems and depression following disclosure. Other adverse consequences included damage to other relationships, such as those with children, parents, and friends; legal consequences, such as arrests; and financial consequences, such as job loss and costs of treatment. (The characteristics of this clinical sample limit its generalizability.) Finally, Cano and O’Leary (2000) found that women whose husbands engaged in infidelity were more likely to experience a major depressive episode.
Infidelity and divorce. Intuitively, it seems that infidelity influences the longevity of primary relationships. Indeed, Amato and Rogers (1997) maintain that infidelity makes an independent contribution to the prediction of divorce, regardless of which spouse was perceived as having caused the problem and regardless of whether husbands or wives were the respondents.
However, Charny and Parnass (1995) note that the negative impact of infidelity on marriage depends on how involved partners are in their infidelity relationship, and Buunk (1987) maintains that EM relationships themselves do not cause relationship dissolution. Instead, he suggests that the overall level of relationship satisfaction, the motives attributed to infidelity, the level of conflict generated over the infidelity, and the attitudes held about long-term infidelities play significant roles in the decision to break away from a relationship. Schneider et al. (1999) report that although 60% of their study participants initially threatened to leave their primary relationship as a result of the disclosure of the infidelity, a threat to leave did not actually predict the eventual outcome: Less than one-quarter of those couples actually separated. One-half of the individuals who stayed in the relationship, despite threatening to leave, said they stayed because one or both partners were actively working on their recovery through therapy and 12-step programs. The rest were unable to take effective action, changed their minds, or decided to “give their spouse another chance” (Schneider et al., 1999, p. 282).
About one-half of Spanier and Margolis’s (1983) sample of 205 divorced individuals said that their marital problems were caused by their spouses’ infidelity. Interestingly, only 6% of the 79 people who had engaged in an EM relationship themselves blamed their marital troubles on their own infidelity. Similarly, when both partners in a dating relationship engage in infidelity, they tend to believe that their partner’s infidelity was more harmful to their primary relationship than was their own (Hansen, 1987). Women who engage in infidelity are more likely to blame themselves for the dissolution of their marriages than are divorced women who have not engaged in infidelity (Spanier & Margolis, 1983), whereas men more often blame their relationship breakups on their partner’s infidelity than their own (Buunk, 1987).
When couples’ marriages do dissolve following the discovery of infidelity, the “faithful” spouse may experience lower life satisfaction and lower self-esteem if they strongly disapproved of their spouse’s infidelity (Spanier & Margolis, 1983). They may also engage in future relationships fearful that the same hurt might reoccur. Interestingly, negative consequences following an infidelity-precipitated divorce may depend on who actually initiated the legal action. Sweeney and Horwitz (2001) found that individuals who initiated a divorce after discovering their spouse’s infidelity actually experienced less depression than those who initiated a divorce for other reasons. When the offending spouse initiated the divorce, however, the faithful spouse was more likely to experience depression.
The Healing Process for Couples Who Have Experienced Infidelity
When thinking about how couples recover from the damage that infidelity inflicts, the issue of disclosure is an important one to consider. How much should be disclosed? How many details? Schneider et al. (1999) report that it is tempting for unfaithful partners to attempt damage control by revealing information piecemeal, and the adverse effects of such drawn-out disclosure were described by several partners in this study. From a clinical standpoint, it may be helpful for couples to understand that disclosure is a process, not a one-time event. Atkins et al. (2005) explored the treatment progress of couples who experienced infidelity in their relationship. They found that couples who kept the infidelity a secret did not improve in treatment-and in some cases deteriorated-as compared with couples who disclosed the infidelity and made it the focus of treatment. The data from this small-sample, pilot study convincingly suggest that disclosure of infidelity is an important, if not essential, component of healing for couples affected by infidelity.
In their small-sample, qualitative study, Olson et al. (2002) offer a three-phase model based on the pattern of experiences shared by participants who discovered their partner’s infidelity. The first phase, described as a roller coaster, is characterized by turmoil in the initial stages of discovery of infidelity. Negative outcomes of the infidelity are most apparent at this stage, and strong feelings oscillate among anger, ambiguity, self-blame, introspection, awareness, deepened appreciation for spouse and family, desire to work on marital relationship, desire to give up, and even gratefulness that something came about to open their eyes to the trouble in their relationship. Second, there is a moratorium stage during which there are still instances of emotional flare-ups, but overall less emotional reactivity. By the end of moratorium, couples who stay together have decided they are going to make the marriage work; having a strong commitment to marriage and family is a critical factor for healing at this point in the relationship. Finally, the third phase is one of trust building and involves taking responsibility, reassurance of commitment, increased communication, and forgiveness. Couples in this phase “reengage,” “open up,” and focus on problems leading up to the infidelity.
Clinical Work with Couples Experiencing Infidelity
In our review of the research, we found only two recent studies that specifically addressed the effective treatment of infidelity. Gordon, Baucom, and Snyder (2004) used a replicated case study design to explore the efficacy of a step-by-step, forgiveness-oriented approach to helping couples recover from infidelity. The first step of treatment deals with the impact of the infidelity; the second explores the context and meanings related to the infidelity; and step three helps the couple move on after the affair. At the end of treatment, the majority of the six couples who participated were significantly less emotionally and/or maritally distressed, and there was a high level of forgiveness in relation to the infidelity. Even though this study is limited by the small, homogenous sample, it shows promise as a treatment for helping these couples and ideally should be replicated with larger, more diverse samples.
In another exploratory study, Atkins et al. (2005) examined the treatment of infidelity using Traditional Behavioral Couple Therapy (TBCT) and Integrative Behavioral Couple Therapy (IBCT). Through their focus on a sample of 19 couples who had experienced infidelity, they compared initial level of distress and course of treatment in couples affected by infidelity and in couples seeking therapy for other reasons. Based on their data, Atkins et al. conclude:
Infidelity couples are notably and reliably more distressed than their non-infidelity peers at pretreatment . . . however, if anything, they improve in therapy at a greater rate, particularly at the end of therapy. Thus, at the end of treatment, the average outcome of couples in which there is an affair is indistinguishable from the outcome of distressed couples without affairs. (p. 148)
They suggest that when working with couples affected by infidelity, it may be useful for clinicians to focus on the relationship as a whole, rather than concentrating only on the infidelity. This small-sample study is worthy of replication.
The Allen and Baucom (2004) study of attachment styles and infidelity suggests some directions for clinicians, particularly concerning the meanings of infidelity and the reasons individuals engage in infidelity. Insights into the meanings of infidelity can be extremely helpful in developing alternative narratives and reframes about why the infidelity occurred. These may also be useful in identifying risk factors and in “affair proofing” a relationship. Finally, emotionally focused couples therapy, with its emphasis on attachment and attachment injuries (Johnson, Makinen, & Millikin, 2001), may be particularly useful in working with couples affected by infidelity, even though there is not yet evidence for effectiveness of this approach specifically with infidelity.
One of the difficulties in doing this kind of research relates to who defines effective treatment. Is treatment “effective” if one partner benefits but the other does not? If a couple decides to end their relationship following couples therapy, and if they are happier because of their split, was the therapy successful? How does one ascertain effectiveness when one partner is satisfied with the outcome and the other is not? In contrast, would therapy be “effective” if a couple stayed together, yet were forever haunted by the painful act of infidelity? In short, the issue of significant outcomes is difficult to measure when it comes to the complexity of infidelity in couples’ relationships. In spite of these challenges, it is critical that researchers attempt to discover what approach or approaches might be helpful to couples struggling with infidelity-related issues.
Other suggestions for therapists. Olson et al. (2002) provide some suggestions for therapists that arise out of their study. First, couples need a map from which they can work in order to understand the process of recovery; second, couples need an active, personable, and advice-giving therapist; and third, couples want to know what happened in their specific relationship so they can prevent the problem from reoccurring. These researchers also suggest that therapists provide specific instruction to couples on the need for support, the need to go slow and allow time for the relationship to heal, and the need for forgiveness.
We believe that much more outcome research focused specifically on the topic of treating infidelity (including different types of infidelity) is needed. Infidelity represents a significant injury to the trust in the relationship; as such, treating infidelity is very different from treating a simple “communication” issue.
SUGGESTIONS FOR FUTURE RESEARCH
Throughout this article, we provided suggestions for future research that could offer relevant and practical knowledge to our understanding of infidelity, and following are some additional suggestions. Although this is by no means a comprehensive list, these ideas seemed particularly pertinent as we conducted our methodological and substantive reviews.
Vulnerability to Infidelity
Researchers need to look at, and more fully understand, what makes people vulnerable to infidelity. Is the process of engaging in infidelity a mutigenerational dilemma, a genetic dilemma, a moral concern, or something else entirely? Future research can answer this question more succinctly to help the field understand the differences between those who engage in infidelity and those who do not. We believe that further research on adult attachment styles and infidelity might lead to interesting data.
The Decision to Enter into Infidelity
Researchers can help clarify the process by which people enter into infidelity relationships in spite of their best intentions. Even high-profile leaders-often individuals with deep religious convictions and with a lot to lose-decide to engage in infidelity. How does the undesirable behavior become desirable? How do people weigh the decision against the extreme cost (Thompson, 1984)?
The Need for More Qualitative Studies of Infidelity
The qualitative studies we found to review for this article gave important in-depth explanations of the processes related to infidelity (see Appendix in Blow & Hartnett, this issue). The field would certainly benefit from many more studies of this nature. Ideally, to understand the process of infidelity, its correlates, and its consequences in greater depth, a dynamic interchange is needed between qualitative and quantitative studies in which in-depth explorations are done in qualitative studies and assertions are falsified in quantitative studies.
The Recovery Processes After Infidelity Has Been Discovered.
As Olson et al. (2002) have pointed out, there is a need for research that delves into the interactional and emotional processes within couples after the disclosure of infidelity. There are no empirical data that address the actual process of the disclosure itself (although the Atkins et al.  study suggests that disclosure is important for treatment success). Finally, future studies need to factor the type and length of infidelity into the recovery processes of couples.
In this review of the research findings on infidelity, we conclude that there are diverse and contradictory findings on the subject. It seems that infidelity researchers have not always been systematic in their research endeavors, and many questions remain unanswered. Given the importance of the issue to couple therapists, the general public, and the rampant misperceptions and misinterpretations of data, we advocate for more robust and complex research in the future to effectively increase our knowledge about this topic.
1 Note: This review explores infidelity in all kinds of committed relationships, not just marriage. Therefore, we generally use the term infidelity when describing studies throughout this article. However, when describing a specific study that uses a more narrow definition of infidelity, we intentionally use the language of that study-such as extramarital (EM) sex.
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Adrian J. Blow
Saint Louis University
Saint Louis University
Adrian J. Blow, PhD, and Kelley Hartnett, MA, Department of Counseling and Family Therapy, Saint Louis University, St. Louis, Missouri.
Address correspondence to Adrian J. Blow, PhD, Saint Louis University, Department of Counseling and Family Therapy, 152 McGannon Hall, 3750 Lindell Boulevard, St. Louis, Missouri, 63108; E-mail: email@example.com
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