Agreement of self-reported and genital measures of sexual arousal in men and women: a meta-analysis

The partner-specific sexual liking and sexual wanting scale: psychometric properties

Inspired by research showing that wanting (one's motivation to engage in an activity) often diverges from liking (one's enjoyment of the activity), this article details the development and validation of a new measure to examine the distinction between sexual wanting and liking within a relationship: the partner-specific sexual liking and wanting (PSSLW) scale. In Study 1, participants (N = 1145; 63% female) completed items intended to measure PSSLW. Factor analysis supported a 15-item two-factor solution that explained 64.7% of the total variance. The partner-specific sexual liking (PSSL) subscale (Cronbach's α = .93) and the partner-specific sexual wanting (PSSW) subscale (Cronbach's α = .87) showed good internal validity. Test-retest reliability on a subsample (n = 30) was high (Pearson's r = .75). In Study 2, participants (N = 67; 71.6% female) completed the PSSLW scale and additional measures of satisfaction and desire. Both scales displayed satisfactory discriminant and convergent validity. In Study 3, participants (N = 2589; 45.3% female) completed the PSSLW scale and answered questions about sexual behavior within their relationships. The two subscales were distinctly correlated with measures of self-reported behavior. Moreover, confirmatory factor analysis (CFA) yielded a good-fit two-factor model, where the Comparative Fit Index (CFI) = .97, Tucker Lewis Index (TLI) = .96, and root mean square error of approximation (RMSEA) = .06. Data from these three studies suggested that PSSLW were distinct, measurable, and valid constructs that have the potential to enrich future studies of sexual experience and behavior within sexual partnerships.

Sex differences in brain activation to emotional stimuli: a meta-analysis of neuroimaging studies

Substantial sex differences in emotional responses and perception have been reported in previous psychological and psychophysiological studies. For example, women have been found to respond more strongly to negative emotional stimuli, a sex difference that has been linked to an increased risk of depression and anxiety disorders. The extent to which such sex differences are reflected in corresponding differences in regional brain activation remains a largely unresolved issue, however, in part because relatively few neuroimaging studies have addressed this issue. Here, by conducting a quantitative meta-analysis of neuroimaging studies, we were able to substantially increase statistical power to detect sex differences relative to prior studies, by combining emotion studies which explicitly examined sex differences with the much larger number of studies that examined only women or men. We used an activation likelihood estimation approach to characterize sex differences in the likelihood of regional brain activation elicited by emotional stimuli relative to non-emotional stimuli. We examined sex differences separately for negative and positive emotions, in addition to examining all emotions combined. Sex differences varied markedly between negative and positive emotion studies. The majority of sex differences favoring women were observed for negative emotion, whereas the majority of the sex differences favoring men were observed for positive emotion. This valence-specificity was particularly evident for the amygdala. For negative emotion, women exhibited greater activation than men in the left amygdala, as well as in other regions including the left thalamus, hypothalamus, mammillary bodies, left caudate, and medial prefrontal cortex. In contrast, for positive emotion, men exhibited greater activation than women in the left amygdala, as well as greater activation in other regions including the bilateral inferior frontal gyrus and right fusiform gyrus. These meta-analysis findings indicate that the amygdala, a key region for emotion processing, exhibits valence-dependent sex differences in activation to emotional stimuli. The greater left amygdala response to negative emotion for women accords with previous reports that women respond more strongly to negative emotional stimuli, as well as with hypothesized links between increased neurobiological reactivity to negative emotion and increased prevalence of depression and anxiety disorders in women. The finding of greater left amygdala activation for positive emotional stimuli in men suggests that greater amygdala responses reported previously for men for specific types of positive stimuli may also extend to positive stimuli more generally. In summary, this study extends efforts to characterize sex differences in brain activation during emotion processing by providing the largest and most comprehensive quantitative meta-analysis to date, and for the first time examining sex differences as a function of positive vs. negative emotional valence. The current findings highlight the importance of considering sex as a potential factor modulating emotional processing and its underlying neural mechanisms, and more broadly, the need to consider individual differences in understanding the neurobiology of emotion.

The desire disorder in research on sexual orientation in women: contributions of dynamical systems theory

Over the past decade, numerous studies have documented fundamental differences between the phenomenology of male and female sexual orientation, largely centering on women's capacity for fluidity in their sexual attractions. The past decade has also witnessed fundamental changes in clinical perspectives on "normal" versus "dysfunctional" patterns of female sexual desire, largely centering on women's greater capacity for responsive and context-dependent sexual desires. In both cases, traditional male-based models of sexuality have been found inadequate to describe women's experiences. I argue that this inadequacy stems from a failure of traditional models to appropriately account for the phenomenon of variability over time, which may constitute a fundamental feature of female sexual phenomenology. I maintain that dynamical systems theory provides a useful and generative approach for reconceptualizing female sexual orientation, because dynamical systems models focus specifically on describing and explaining complex patterns of change over time. I review the key properties of dynamical systems models and provide an illustrative model of how this approach might yield new perspectives on female sexual orientation.

Effects of gender and relationship context in audio narratives on genital and subjective sexual response in heterosexual women and men

Previous research suggests that heterosexual women's sexual arousal patterns are nonspecific; heterosexual women demonstrate genital arousal to both preferred and nonpreferred sexual stimuli. These patterns may, however, be related to the intense and impersonal nature of the audiovisual stimuli used. The current study investigated the gender specificity of heterosexual women's sexual arousal in response to less intense sexual stimuli, and also examined the role of relationship context on both women's and men's genital and subjective sexual responses. Assessments were made of 43 heterosexual women's and 9 heterosexual men's genital and subjective sexual arousal to audio narratives describing sexual or neutral encounters with female and male strangers, friends, or long-term relationship partners. Consistent with research employing audiovisual sexual stimuli, men demonstrated a category-specific pattern of genital and subjective arousal with respect to gender, while women showed a nonspecific pattern of genital arousal, yet reported a category-specific pattern of subjective arousal. Heterosexual women's nonspecific genital response to gender cues is not a function of stimulus intensity or relationship context. Relationship context did significantly affect women's genital sexual arousal--arousal to both female and male friends was significantly lower than to the stranger and long-term relationship contexts--but not men's. These results suggest that relationship context may be a more important factor in heterosexual women's physiological sexual response than gender cues.

Is sexual concordance related to awareness of physiological states?

Sexual concordance refers to the degree to which two aspects of human sexual arousal (genital response and self-reported sexual arousal) correspond with each other. Researchers have consistently reported a sex difference in sexual concordance: The relationship between genital responses and reported feelings of sexual arousal in men is positive and large, whereas the relationship in women is positive but much smaller than that seen in men. The study of interoception--people's awareness of their physiological states--reveals a similar sex difference: Men are more aware of a variety of (non-genital) responses (e.g., heart rate) than women in the laboratory. The purpose of the current study was to investigate whether the sex difference in sexual concordance was related to a broader sex difference in interoception. Twenty men and 20 women were presented with twelve 90 s sexual and non-sexual film clips while their genital responses, heart rate, and respiration rate were measured. Participants also estimated their physiological responses. As expected, men were significantly more sexually concordant than women. Men were also significantly more aware of their heart rate, but there was no significant sex difference in respiration rate awareness. Sexual concordance was not significantly correlated with either heart rate or respiration rate awareness. The results suggest that the sex difference in sexual concordance may be a unique phenomenon, separate from general awareness of physiological states.

Viewing time as a measure of bisexual sexual interest

Studies of bisexual sexual interest have focused mostly on measures of genital arousal in bisexual men and have generally failed to find evidence of a bisexual pattern of genital arousal. Bisexual women have rarely been studied and other measures of sexual interest have not been used to study bisexual interest in either sex. In this study, we examined a non-genital measure of sexual interest, viewing time, among 16 bisexual men, 19 bisexual women, 15 heterosexual men, 15 heterosexual women, 15 homosexual men, and 10 homosexual women. Sexual orientation was determined from a self-report questionnaire. Stimuli were pictures of males and females of all five Tanner stages of sexual development. Participants were asked to rate the sexual appeal of the individuals depicted in the pictures, while the time taken to provide a response was covertly measured. Using a signed index that compared viewing times to pictures of sexually mature males and females, bisexual men and bisexual women did not look longer at pictures of one gender, whereas the other four groups had longer viewing times for pictures of one gender. Using an absolute index, the three groups of women showed a similar (and low) degree of gender preference. All groups showed longer viewing times for sexually mature individuals than for sexually immature individuals, suggesting that the viewing time responses of bisexual men and women were not produced by a general tendency to look indiscriminately at all pictures. There were small to moderate correlations between viewing times and rated sexual appeal in all groups. Results suggest that viewing time can be used to detect a bisexual pattern of sexual interest in bisexual men and bisexual women.

Feederism: an exaggeration of a normative mate selection preference?

Quinsey and Lalumière (1995) suggested that some, if not most, paraphilias are exaggerated manifestations of more normative and functional mate selection preferences. The present study tested whether Feederism, a fat fetish focused on erotic eating, feeding, and gaining weight, is an exaggeration of a sexual arousal pattern commonly seen in the general population. Thirty participants (15 men and 15 women) recruited from the general population were assessed using penile plethysmography and vaginal photoplethysmography, respectively. None of the participants were self-identified Feeders or Feedees. Participants were shown sexual, neutral, and feeding still images while listening to audio recordings of sexual, neutral, and feeding stories. Participants did not genitally respond to feeding stimuli. However, both men and women subjectively rated feeding stimuli as more sexually arousing than neutral stimuli. We discuss the discordance between physiological and self-reported sexual arousal in the context of sex differences in sexual concordance and implications for future research.

A brief mindfulness-based cognitive behavioral intervention improves sexual functioning versus wait-list control in women treated for gynecologic cancer

GOAL

The goal of this study was to evaluate a mindfulness-based cognitive behavioral intervention for sexual dysfunction in gynecologic cancer survivors compared to a wait-list control group.

METHODS

Thirty-one survivors of endometrial or cervical cancer (mean age 54.0, range 31-64) who self-reported significant and distressing sexual desire and/or sexual arousal concerns were assigned either to three, 90-minute mindfulness-based cognitive behavior therapy sessions or two months of wait-list control prior to entering the treatment arm. Validated measures of sexual response, sexual distress, and mood, as well as laboratory-evoked physiological and subjective sexual arousal were assessed at pre-, one month post-, and 6-months following treatment.

RESULTS

There were no significant effects of the wait-list condition on any measure. Treatment led to significant improvements in all domains of sexual response, and a trend towards significance for reducing sexual distress. Perception of genital arousal during an erotic film was also significantly increased following the intervention despite no change in physiologically-measured sexual arousal.

CONCLUSIONS

A brief mindfulness-based intervention was effective for improving sexual functioning. Geographic restrictions permitted only a select sample of survivors to participate, thus, the generalizability of the findings is limited. Future studies should aim to develop online modalities for treatment administration to overcome this limitation.

Support for a fluid-continuum model of sexual orientation: a large-scale Internet study

In a study with 17,785 subjects obtained over the Internet from the United States and 47 other countries, Kinsey's hypothesis that sexual orientation lies on a continuum was supported. Self-identifications of subjects as gay, straight, bisexual, and other corresponded to broad, skewed distributions, suggesting that such terms are misleading for many people. Sexual orientation range-roughly, how much flexibility someone has in expressing sexual orientation-was also measured. The results support a fluid-continuum model of sexual orientation, according to which genetic and environmental factors determine both the size of the sexual orientation range and the point at which an individual's sexual orientation is centered on the continuum.

Neural correlates of exposure to subliminal and supraliminal sexual cues

Sexual arousal is thought to be the result of two levels of processing: conscious and unconscious. Whereas some research exists on the neural correlates related with conscious exposure to sexual stimuli, there are no parallel data regarding unconscious or subliminal exposure to such stimuli. In the present study, we therefore compared brain activation of 39 participants (20 women) as they were exposed to supraliminal vs subliminal sexual stimuli. Supraliminal exposure was associated with greater activation in areas that were previously associated with sexual arousal (e.g. caudate nucleus and thalamus) as well as areas that were previously associated with control (e.g. orbitofrontal cortex and cingulate cortex). In contrast, subliminal exposure was mainly related to activation in areas previously associated with sexual arousal. Men and women exhibited theoretically meaningful differences in patterns of activation associated with supra- and subliminal exposure. Findings are discussed with regard to sexual arousal and regulatory processes.

Evidence for a curvilinear relationship between sympathetic nervous system activation and women's physiological sexual arousal

There is increasing evidence that women's physiological sexual arousal is facilitated by moderate sympathetic nervous system (SNS) activation. Literature also suggests that the level of SNS activation may play a role in the degree to which SNS activity affects sexual arousal. We provide the first empirical examination of a possible curvilinear relationship between SNS activity and women's genital arousal using a direct measure of SNS activation in 52 sexually functional women. The relationship between heart rate variability (HRV), a specific and sensitive marker of SNS activation, and vaginal pulse amplitude (VPA), a measure of genital arousal, was analyzed. Moderate increases in SNS activity were associated with higher genital arousal, while very low or very high SNS activation was associated with lower genital arousal. These findings imply that there is an optimal level of SNS activation for women's physiological sexual arousal.

The Relationship between female sexual arousal and response bias in women with and without provoked vestibulodynia

Smaller correlations have typically been found between genital and subjective sexual arousal in female versus male samples. This study evaluated the association between response bias and the relationship between genital and subjective arousal (i.e., concordance) in women with (n = 20) and without (n = 21) provoked vestibulodynia. Participants (M = 21.27 years, SD = 2.27) underwent blood flow imaging via a laser Doppler imager to assess genital responsiveness to a visual erotic stimulus; subjective arousal was assessed during and following the film. The relationships between three types of subjective arousal ratings (perceived sexual arousal, perceived genital responsiveness, and reported desire to engage in sexual activity) and two forms of socially desirable responding (impression management and self-deceptive enhancement) were examined. Concordance estimates were statistically non-significant in both groups, with the exception of the desire to engage in sexual activity, which was moderately correlated with genital arousal in the control group. Impression management was not a statistically significant moderator of the relationship between genital and subjective arousal, but was moderately negatively related to the three forms of subjective arousal ratings in the provoked vestibulodynia group. The results highlight the importance of assessing response bias in laboratory studies comparing women with and without sexual dysfunction.

Physiological and subjective sexual arousal in self-identified asexual women

Asexuality can be defined as a lifelong lack of sexual attraction. Empirical research on asexuality reveals significantly lower self-reported sexual desire and arousal and lower rates of sexual activity; however, the speculation that there may also be an impaired psychophysiological sexual arousal response has never been tested. The aim of this study was to compare genital (vaginal pulse amplitude; VPA) and subjective sexual arousal in asexual and non-asexual women. Thirty-eight women between the ages of 19 and 55 years (10 heterosexual, 10 bisexual, 11 homosexual, and 7 asexual) viewed neutral and erotic audiovisual stimuli while VPA and self-reported sexual arousal and affect were measured. There were no significant group differences in the increased VPA and self-reported sexual arousal response to the erotic film between the groups. Asexuals showed significantly less positive affect, sensuality-sexual attraction, and self-reported autonomic arousal to the erotic film compared to the other groups; however, there were no group differences in negative affect or anxiety. Genital-subjective sexual arousal concordance was significantly positive for the asexual women and non-significant for the other three groups, suggesting higher levels of interoceptive awareness among asexuals. Taken together, the findings suggest normal subjective and physiological sexual arousal capacity in asexual women and challenge the view that asexuality should be characterized as a sexual dysfunction.

Patterns of sexual arousal in homosexual, bisexual, and heterosexual men

The purpose of this study was to determine if self-identified bisexual, heterosexual, and homosexual men show differential genital and subjective arousal patterns to video presentations of bisexual, heterosexual, male homosexual, and lesbian sexual interactions. It was predicted that, relative to heterosexual and homosexual stimuli, bisexual men would show the highest levels of sexual arousal to bisexual erotic material, while this stimulus would induce relatively low levels of response in heterosexual and homosexual men. A sample of 59 men (19 homosexual, 13 bisexual, and 27 heterosexual) were presented with a series of 4-min sexual videos while their genital and subjective sexual responses were measured continuously. Bisexual men did not differ significantly in their responses to male homosexual stimuli (depicting men engaging in sex) from homosexual men, and they did not differ significantly in their responses to heterosexual (depicting two women, without same-sex contact, engaged in sex with a man) and lesbian (depicting women engaging in sex) stimuli from heterosexual men. However, bisexual men displayed significantly higher levels of both genital and subjective sexual arousal to a bisexual stimulus (depicting a man engaged in sex with both a man and a woman) than either homosexual or heterosexual men. The findings of this study indicate that bisexuality in men is associated with a unique and specific pattern of sexual arousal.

Theoretical issues in the study of asexuality

Academic interest in asexual people is new and researchers are beginning to discuss how to proceed methodologically and conceptually with the study of asexuality. This article explores several of the theoretical issues related to the study of asexuality. Researchers have tended to treat asexuality either as a distinct sexual orientation or as a lack of sexual orientation. Difficulties arise when asexual participants are inconsistent in their self-identification as asexual. Distinguishing between sexual and romantic attraction resolves this confusion, while simultaneously calling into question conceptualizations of the asexual population as a single homogenous group. Arguments are considered in favor of exploring diversity within the asexual population, particularly with respect to gender and romantic orientation, proposing that the categorical constructs employed in (a)sexuality research be replaced with continuous ones. Furthermore, given the recently noted bias toward including only self-identified asexuals, as opposed to non-self-identified asexuals or "potential-asexuals," in research about asexuality, the nature and meaning of asexual self-identification are discussed. Particular attention is paid to the theoretical importance of acknowledging asexual self-identification or lack thereof in future research into asexuality. This article discusses what these current theoretical issues mean for the study of asexuality and sexuality more generally, including a brief consideration of ethical implications for research with asexual participants. Finally, directions for future research are suggested.

Sexual arousal in men: a review and conceptual analysis

Sexual arousal is an emotional/motivational state that can be triggered by internal and external stimuli and that can be inferred from central (including verbal), peripheral (including genital), and behavioral (including action tendencies and motor preparation) responses. This article, while focusing on sexual arousal in men, provides a conceptual analysis of this construct, reviews models of sexual arousal, and discusses the usefulness of perspectives derived from motivation and emotion research in improving our understanding of its determinants and behavioral correlates. In this, it considers the role of genital feedback in men's subjective sexual arousal and the connections between sexual arousal and sexual desire. Future research and definitions may increasingly focus on its central integrative functions (as opposed to its input and output characteristics). Yet, the study of sexual arousal can be expected to continue to benefit from the measurement of its genital, verbal, and behavioral components. Instances of discordance between response components suggest that they are, at least in part, under the control of different mechanisms, and it is proposed that a better understanding of sexual arousal will prove contingent on a better understanding of such mechanisms and the conditions under which they converge and diverge.

The varied nature of women's sexuality: unresolved issues and a theoretical approach

During the 20th century there were clear indications that the socio-cultural suppression of women's sexuality had lessened, revealing a marked variability of women's sexual expression. In this article we review the recent literature to explore explanations for this variability. It is clear that we know little about the nature of sexual desire, and in particular, what it is that is desired. There is also now substantial evidence that vaginal response, as measured by vaginal pulse amplitude, is a relatively automatic response to perception of sexual stimuli, regardless of whether these stimuli are perceived positively or result in subjective arousal. This is considered as a possible mechanism that allows vaginal intercourse without pain, even when the woman is not sexually aroused. The roles of androgens and estrogen in women's sexuality remain uncertain. The evidence is, however, consistent with there being a testosterone-dependent component of women's sexuality that is more important for some women than others. Finally, a new theoretical model is presented that aims to resolve these uncertainties and that proposes different types of women's sexuality. Once we have a better understanding of "normal" female sexuality, in its various forms, our ability to develop effective treatments for women's sexual problems should improve.

Women's sexual arousal: effects of high alcohol dosages and self-control instructions

The basic relationship between alcohol and women's sexual arousal - especially genital arousal - received little research attention for nearly 30 years (e.g. Wilson and Lawson, 1978) until very recently (e.g. George et al., 2009). To investigate hypotheses based on earlier findings and Alcohol Myopia Theory (AMT), two experiments evaluated the effects of high blood alcohol concentrations (BACs) and arousal instructional demands on indices of vaginal responding and self-reported sexual arousal. In Experiment 1, self-control instructions to maximize (versus suppress) arousal increased peak and average Vaginal Pulse Amplitude (VPA) change. Self-control also interacted with a target BAC of .08% (versus .00%) to influence latency to peak arousal onset: Intoxicated women instructed to maximize showed a shorter latency to peak arousal than did intoxicated women instructed to suppress; however, sober women showed an undifferentiated pattern. Also, in Experiment 1, the target BAC of .08% had no effect on VPA or subjective arousal measures. In Experiment 2, a target BAC of .10% (versus .00%) attenuated peak change and average change in VPA, but this dosage had no effects on latency to peak achieved arousal, or on subjective arousal. Instructions to maximize arousal (versus no instruction) had no effect on any arousal measures. Overall, among young moderate drinking women, alcohol had attenuating effects but only at the higher dosage. Maximize versus suppress instructions about arousal had predicted effects on arousal and interactive effects on latency, but only at the lower dosage. The findings highlight the importance of dosage and contextual factors in alcohol's impact on the variability of women's sexual responding.

Androgenic hormones and aging--the link with female sexual function

In women, sexual function, hormones and aging are inextricably related. Sexual activity in women involves interest and motivation, the ability to become aroused and achieve orgasm, the pleasure of the experience and subsequent personal satisfaction. Androgens, as endogenous hormones or given as a therapy, potentially influence female sexual function, with research into the effects of exogenous androgens in women mostly devoted to effects on sexual desire. Some studies have been conducted to delineate the effects of testosterone on arousal, however arousal determined by laboratory measures does not always correlate with subjective reporting of a sensation of arousal. Overall large randomised controlled trials of exogenous testosterone show benefits over placebo on sexual desire, arousal, orgasm, pleasure and satisfaction. The aspects of consideration of androgen therapy for women that continue to stimulate debate in this therapeutic area include whether female sexual dysfunction is a condition that merits pharmacotherapy, how effective is such treatment and whether testosterone therapy is safe.

The effects of acute ethanol consumption on sexual response and sexual risk-taking intent

Two theories of sexual risk taking (disinhibition and alcohol myopia) were tested using genital measures of sexual response and computer measures of sexual risk propensity. A total of 44 men and women completed two sessions comparing responses to erotic films while consuming alcohol (breath alcohol doses were .025 g/kg and .08 g/kg) or juice alone. After consuming alcohol, more sexual arousal was reported in response to neutral films and at a breath alcohol level of .08 g/kg as compared to no alcohol. Genital responses for men and women increased during sexual films, but men did not respond as strongly when breath alcohol level was .08 g/kg. Intentions to have intercourse with a new partner at baseline predicted the level of sexual arousal reported. As self-reported sexual arousal increased in response to sexual films and higher alcohol dose, the intent to engage in intercourse with a new partner increased. Alcohol dose was not related to later sexual intercourse intentions. With no direct relationship of alcohol and intercourse intentions, results appear more consistent with a disinhibition model of sexual arousal.

Sexual arousal in East Asian and Euro-Canadian women: a psychophysiological study

INTRODUCTION

Studies of ethnic differences in self-report measures of sexuality have shown East Asian women to be more sexually conservative and less sexually experienced than Caucasian women. There is also strong evidence supporting the notion of ethnic group differences in general measures of nonsexual psychophysiological arousal; however, there have been no previous studies exploring ethnicity and physiological sexual arousal.

AIM

The objective of this study was to explore group differences in self-reported and physiological sexual arousal in Euro-Canadian and East Asian women living in Canada; we also aimed to explore the association between level of acculturation (both mainstream and heritage) and sexual arousal in East Asian women only.

METHODS

Seventy-five women (N=38 Euro-Canadian, N=37 East Asian) completed a battery of questionnaires and underwent psychophysiological sexual arousal testing using the vaginal photoplethysmograph. They also completed a self-report measure of subjective arousal before and after erotic stimulus exposure.

MAIN OUTCOME MEASURES

All women completed the Female Sexual Function Index, Vancouver Index of Acculturation, and Sexual Beliefs and Information Questionnaire. Change in genital sexual arousal (vaginal pulse amplitude; VPA), and change in subjective sexual arousal were measured during exposure to erotic stimuli.

RESULTS

The groups did not differ in the percent increase in VPA induced by erotic stimuli, nor was there a correlation between VPA and subjective sexual arousal. Among East Asian women alone, neither heritage nor mainstream acculturation was correlated with change in VPA.

CONCLUSIONS

East Asian and Euro-Canadian women who show similar ratings of sexual behaviors and self-reported sexual arousal do not differ in physiological or subjective arousal induced by erotic stimuli in the laboratory.

Gender differences in sexual attitudes and behaviors: a review of meta-analytic results and large datasets

Gender differences in sexual attitudes and behaviors are typically believed to be large, yet recent evidence suggests that some gender differences in sexuality are much smaller than common knowledge would suggest. This article reviews gender differences in sexual attitudes and behaviors as reported by major meta-analyses and large datasets. In particular, this article reviews gender differences in heterosexual intercourse, masturbation, pornography use, attitudes toward premarital sex, and gender differences in same-gender sexuality. Evolutionary psychology, social cognitive learning theory, and social structural theory are explored as possible explanations for gender differences in sexuality.

Circular and linear modeling of female sexual desire and arousal

There is debate in the scientific literature regarding which model most accurately represents the female sexual response. Traditionally, sex research has been conducted within the framework of the linear sexual response model proposed by Masters and Johnson, modified by Kaplan, then Robinson. Criticism of linear models prompted the development of a composite model of the female sexual response by Basson et al., which included linear and circular pathways. This review aims to systematically assess published studies to determine the extent to which circular and linear models or pathways reflect the female sexual response. Medline, EMBASE, and PsychINFO databases were searched for original data papers and review articles. Inclusion criteria were that articles were published since 1990, in English, and compared linear and circular sexual response models or addressed aspects of these models. Reviews were required to be systematic and include a meta-analysis. Of the 898 studies identified through the initial literature search, 13 original studies and one review met the inclusion criteria. Two studies directly compared models providing limited evidence that most women identify with linear sexual response pathways. However, there is increasing evidence that circular pathways may accurately reflect some aspects of the female sexual response. Further comparative studies are encouraged.

Effects of mindfulness training on body awareness to sexual stimuli: implications for female sexual dysfunction

OBJECTIVES

Treatments of female sexual dysfunction have been largely unsuccessful because they do not address the psychological factors that underlie female sexuality. Negative self-evaluative processes interfere with the ability to attend and register physiological changes (interoceptive awareness). This study explores the effect of mindfulness meditation training on interoceptive awareness and the three categories of known barriers to healthy sexual functioning: attention, self-judgment, and clinical symptoms.

METHODS

Forty-four college students (30 women) participated in either a 12-week course containing a "meditation laboratory" or an active control course with similar content or laboratory format. Interoceptive awareness was measured by reaction time in rating physiological response to sexual stimuli. Psychological barriers were assessed with self-reported measures of mindfulness and psychological well-being.

RESULTS

Women who participated in the meditation training became significantly faster at registering their physiological responses (interoceptive awareness) to sexual stimuli compared with active controls (F(1,28) = 5.45, p = .03, η(p)(2) = 0.15). Female meditators also improved their scores on attention (t = 4.42, df = 11, p = .001), self-judgment, (t = 3.1, df = 11, p = .01), and symptoms of anxiety (t = -3.17, df = 11, p = .009) and depression (t = -2.13, df = 11, p < .05). Improvements in interoceptive awareness were correlated with improvements in the psychological barriers to healthy sexual functioning (r = -0.44 for attention, r = -0.42 for self-judgment, and r = 0.49 for anxiety; all p < .05).

CONCLUSIONS

Mindfulness-based improvements in interoceptive awareness highlight the potential of mindfulness training as a treatment of female sexual dysfunction.

Prepared for Anything?

Men’s genital arousal occurs in response to a limited number of sexual stimuli, whereas women’s genital arousal occurs in response to a wide range of sexual stimuli, including those depicting nonpreferred cues. Researchers have hypothesized that women’s nonspecific pattern of genital arousal prepares the body for sexual activity, thus functioning to protect the genital organs against injury. If this hypothesis is correct, women should show genital responses to any cues suggesting sexual activity, even unappealing cues that involve nonconsensual sex and extreme violence. Fifteen men and 15 women listened to fourteen 2-min audiotaped narratives that depicted an interaction between a man and a woman and that varied factorially according to the presence of consent, violence, and sexual activity. The results support the preparation hypothesis: Men showed the greatest genital arousal in response to narratives depicting consensual, nonviolent sex, whereas women showed similar responses to all the narratives involving sexual activities, including those describing a sexual assault.

Testosterone therapy for reduced libido in women

Modest benefit has been shown from transdermal testosterone therapy given to postmenopausal women with reduced sexual desire. An increased frequency of satisfying sexual encounters and intensity of sexual desire and response has been shown in medically and psychiatrically healthy women able to have 2-3 satisfying sexual experiences each month before therapy commences. Women more clearly sexually dysfunctional in keeping with currently proposed definitions of sexual disorder have not been studied. Numerous factors are known to influence women's sexual desire with mood and feelings towards the partner showing the most robust associations. How to identify women whose low desire might stem from low testosterone activity remains unknown: neither serum levels of testosterone nor its metabolites correlate with desire or function. Production of androgens in the brain, sensitivity of the androgen receptors, and activity of cofactors are all potentially relevant confounds. The long-term safety of systemic testosterone with or without estrogen is unknown but necessary as women's sexual lives tend to endure as long as there is an active partner.

The DSM diagnostic criteria for female sexual arousal disorder

This article reviews and critiques the DSM-IV-TR diagnostic criteria for Female Sexual Arousal Disorder (FSAD). An overview of how the diagnostic criteria for FSAD have evolved over previous editions of the DSM is presented and research on prevalence and etiology of FSAD is briefly reviewed. Problems with the essential feature of the DSM-IV-TR diagnosis-"an inability to attain, or to maintain...an adequate lubrication-swelling response of sexual excitement"-are identified. The significant overlap between "arousal" and "desire" disorders is highlighted. Finally, specific recommendations for revision of the criteria for DSM-V are made, including use of a polythetic approach to the diagnosis and the addition of duration and severity criteria.