Attentional and affective processing of sexual stimuli in women with hypoactive sexual desire disorder

Interplay between sexual excitation and inhibition: impact on sexual function and neural correlates of erotic stimulus processing in women

Background

As outlined by the dual control model (DCM), individual differences in the regulation of sexual arousal following sexual stimulation depend on two distinct neurophysiological processes: sexual excitation (SE) and sexual inhibition (SI). Although associations with sexual function, behavior, and cue processing have been demonstrated in previous research, underlying neural correlates remain insufficiently explored. Moreover, interactive effects of SE/SI as proposed by the DCM, as well as factors impacting SE/SI properties, such as the use of oral contraceptives (OCs), have not received adequate attention in existing research.

Methods

90 healthy, sexually active women (n = 51 using OCs, n = 39 naturally cycling) completed an Emotional-Picture-Stroop-Paradigm (EPSP) while a 64-channel EEG was recorded. LPP amplitudes toward erotic and neutral stimuli were consecutively computed as a marker of motivational salience and approach motivation. Additionally, women provided self-reports of SE/SI and sexual function. Moderation analyses were performed to assess interactive effects of SE/SI in predicting LPP amplitudes and sexual function.

Results

Sexual function was negatively associated with SI levels but unrelated to SE. Higher SI was associated with reduced LPP amplitudes in response to erotic stimuli. This negative association was, however, attenuated for women high in SE, suggesting interactive effects of SE/SI. Furthermore, women using OCs reported lower SE compared to naturally cycling women.

Conclusion

The observed findings provide additional psychophysiological evidence supporting the DCM and underscore the relevance of interactive SE/SI effects in stimulus processing and approach motivation. They also highlight the possible impact of OCs on psychosexual variables that warrants further research.

Effects of Group Mindfulness-Based Cognitive Therapy versus Supportive Sex Education on Sexual Concordance and Sexual Response Among Women with Sexual Interest/Arousal Disorder

Low interest in sexual activity and impaired sexual response are among women's most frequent sexual concerns. Mindfulness-based treatments improve low sexual desire and arousal and associated distress. One theorized mechanism of change is the cultivation of increased mind-body awareness via greater concordance between psychological and physiological components of sexual response. We examined sexual psychophysiology data from 148 cisgender women randomized to receive mindfulness-based cognitive therapy (MCBT: n = 70) or supportive sex education (STEP: n = 78) over eight weekly group sessions. Women completed in-lab assessments of subjective, affective, and genital sexual responses to an erotic film pre- and post-treatment, and at 6- and 12-month follow-ups. Both groups showed positive changes in sexual and affective responses, but these were generally more pronounced for MBCT. MCBT increased sexual concordance to a greater degree, and gains in sexual concordance predicted improvements in sexual distress throughout treatment.

Eye-tracking does not reveal early attention processing of sexual copulatory movement in heterosexual men and women

Men and women respond differently when presented with sexual stimuli. Men's reaction is gender-specific, and women's reaction is gender-nonspecific. This might be a result of differential cognitive processing of sexual cues, namely copulatory movement (CM), which is present in almost every dynamic erotic stimulus. A novelty eye-tracking procedure was developed to assess the saliency of short film clips containing CM or non-CM sexual activities. Results from 29 gynephilic men and 31 androphilic women showed only small and insignificant effects in attention bias and no effects in attentional capture. Our results suggest that CM is not processed differently in men and women and, therefore, is not the reason behind gender-nonspecific sexual responses in women.

The Sexual Incentive Motivation Model and Its Clinical Applications

Sexual motivation (desire) requires the simultaneous presence of an active central motive state and a stimulus with sexual significance. Once activated, sexual motivation leads to visceral responses and approach behaviors directed toward the emitter of the sexual stimulus. In humans, such behaviors follow cognitive evaluation of the context, including predictions of the approached individual's response. After successful approach and establishment of physical contact, manifest sexual activities may be initiated. Sexual interaction is associated with and followed by a state of positive affect in most animals, whereas aversive consequences may be experienced by humans. The affective reactions may become associated with stimuli present during sexual interaction, and these stimuli may thereby alter their incentive properties. Here we show how the incentive motivation model can be used to explain the origins and possible treatments of sexual dysfunctions, notably disorders of desire. We propose that associations formed between negative outcomes of sexual interaction and the salient stimuli, for example, the partner, underlies hypoactive desire disorder. Highly positive outcomes of sexual interaction enhance the incentive value of the stimuli present, and eventually lead to hyperactive sexual desire. Treatments aim to alter the impact of sexual incentives, mainly by modifying cognitive processes.

What can the eyes tell us about atypical sexual preferences as a function of sex and age? Linking eye movements with child-related chronophilias

Visual attention plays a central role in current theories of sexual information processing and is key to informing the use of eye-tracking techniques in the study of typical sexual preferences and more recently, in the study of atypical preferences such as pedophilia (prepubescent children) and hebephilia (pubescent children). The aim of this theoretical-empirical review is to connect the concepts of a visual attention-based model of sexual arousal processing with eye movements as indicators of atypical sexual interests, to substantiate the use of eye-tracking as a useful indirect measure of sexual preferences according to sex and age of the stimuli. Implications for research are discussed in terms of recognizing the value, scope and limitations of eye-tracking in the study of pedophilia and other chronophilias in males and females, and the generation of new hypotheses using this type of indirect measure of human sexual response.

The Brain Activation-Based Sexual Image Classifier (BASIC): A Sensitive and Specific fMRI Activity Pattern for Sexual Image Processing

Previous studies suggest there is a complex relationship between sexual and general affective stimulus processing, which varies across individuals and situations. We examined whether sexual and general affective processing can be distinguished at the brain level. In addition, we explored to what degree possible distinctions are generalizable across individuals and different types of sexual stimuli, and whether they are limited to the engagement of lower-level processes, such as the detection of visual features. Data on sexual images, nonsexual positive and negative images, and neutral images from Wehrum et al. (2013) (N = 100) were reanalyzed using multivariate support vector machine models to create the brain activation-based sexual image classifier (BASIC) model. This model was tested for sensitivity, specificity, and generalizability in cross-validation (N = 100) and an independent test cohort (N = 18; Kragel et al. 2019). The BASIC model showed highly accurate performance (94–100%) in classifying sexual versus neutral or nonsexual affective images in both datasets with forced choice tests. Virtual lesions and tests of individual large-scale networks (e.g., visual or attention networks) show that individual networks are neither necessary nor sufficient to classify sexual versus nonsexual stimulus processing. Thus, responses to sexual images are distributed across brain systems.

Using Three Indirect Measures to Assess the Role of Sexuality-Related Associations and Interpretations for Women's Sexual Desire: An Internet-Based Experimental Study

Theoretical models emphasize the role of both automatic appraisals (i.e., associations) and conscious appraisals (i.e., interpretations) for sexual desire. Studies on sexuality-related appraisals have not combined self-report measures and experimental paradigms in order to compare the relevance of associations or interpretations. The aim of this study was to assess the relative contribution of both associations and interpretations to the explanation of low sexual desire in women. Toward this goal, indirect measures assessing associations (via a Single Target Implicit Association Test [STIAT]) and interpretations (via a Scrambled Sentences Test [SST] and a scenario task) were administered in a sample of 263 women (M_age = 27.90, SD 8.27) with varying levels of sexual desire and different sexual orientations (exclusively heterosexual women: 54.6%). Negative sexuality-related interpretations as assessed with two variants of the SST as well as the scenario task added to the explanation of lower sexual desire in women. Negative associations as measured with the STIAT were predictive of lower sexual desire only in women who did not indicate an exclusively heterosexual orientation. In this study, sexuality-related interpretations were more relevant to women's sexual desire than automatic associations. Future studies should assess the causal mechanism underlying sexuality-related interpretations (e.g., by evaluating whether these can be changed via cognitive bias modification techniques or psychological treatments).

Sexual Attentional Bias in Young Adult Heterosexual Men: Attention Allocation Following Self-Regulation

Being sexually aroused can lead to a stronger propensity to engage in sexual risk-taking and sexually coercive behaviors possibly by narrowing attentional focus toward immediate gratification rather than long-term consequences. The goal of this paper was to investigate the attentional processes implicated in sexual self-regulation failure and its moderating factors, namely having a stronger sensitivity to sexual cues (dual control model) or being less able to implement behavioral intentions (action control theory) following a first effortful task. A total of 82 young adult heterosexual men completed a Dot Probe task to assess their attentional bias toward sexual stimuli. Effortful control was manipulated using a Stroop task. Regardless of conditions, higher sexual excitability was predictive of a stronger attentional bias toward sexual cues, while higher inhibition due to threat of performance failure was predictive of a lower bias for such cues. In the experimental condition, action-oriented individuals were able to negate this attentional bias by staying more focused on the task, while state-oriented participants showed higher orientation toward the sexual cues and thus a higher bias. These results suggest that both higher-order processes, like intention implementation, and lower-order processes, like sexual inhibition and excitation systems, are the key to regulation failure.

Visual Attention and Sexual Function in Women

Purpose of Review

Theoretical models situate attention as integral to the onset and regulation of sexual response and propose that problems with sexual response and subsequent sexual dysfunction result from insufficient attentional processing of sexual stimuli. The goal of this paper is to review literature examining the link between attentional processing of sexual stimuli and sexual function in women. Specifically, we sought to understand whether women with and without sexual dysfunction differ in their visual attention to sexual stimuli and examined the link with sexual response, which would support attention as a mechanism underlying sexual dysfunction.

Recent Findings

Across women with and without sexual concerns, sexual stimuli are preferentially attended to relative to nonsexual stimuli, suggesting that sexual stimuli are more salient than nonsexual stimuli. Differences between women with and without sexual dysfunction emerge when examining visual attention toward the most salient features of sexual stimuli (e.g., genital regions depicting sexual activity). Consistent with theoretical models, visual attention and sexual response are related, such that increasing attention to sexual cues facilitates sexual arousal, whereas reduced attention to sexual stimuli appears to suppress sexual arousal, which may contribute to sexual difficulties in women.

Summary

Taken together, the research supports the role of visual attention in sexual response and sexual function. These findings provide empirical support for interventions that target attentional processing of sexual stimuli. Future research is required to further delineate the specific attentional mechanisms involved in sexual response and investigate whether these are modifiable. This knowledge may be beneficial for developing novel psychological interventions targeting attentional processes in the treatment of sexual dysfunctions.

Cognitive processing of sexual cues in asexual individuals and heterosexual women with desire/arousal difficulties

Asexuality is defined as a unique sexual orientation characterized by a lack of sexual attraction to others. This has been challenged, with some experts positing that it is better explained as a sexual dysfunction. Sexual Interest/Arousal Disorder (SIAD) is characterized by absent/reduced sexual interest/arousal paired with personal distress, with two subtypes: acquired and lifelong. Research suggests that while asexuality and acquired SIAD are distinct entities, there may be overlap between asexuality and lifelong SIAD. Findings from studies using eye-tracking and implicit association tasks suggest that these methodologies might differentiate these groups on the basis of their neural mechanisms. However, no study has compared their cognitive processing of sexual cues, and the literature on lifelong SIAD is minimal. The current study tested differences in the cognitive processing of sexual cues between asexual individuals and women with SIAD (lifelong and acquired). Forty-two asexual individuals and 25 heterosexual women with SIAD (16: acquired; 9: lifelong) completed three study components: a visual attention task, a Single Category-Implicit Association Task, and the sex semantic differential. ANOVAs examined group differences in: 1) visual attention to erotic cues, 2) implicit appraisals of sexual words, and 3) explicit appraisals of sex. Women with SIAD displayed a controlled attention preference for erotic images and areas of sexual contact, with longer dwell times to these areas relative to asexual individuals, who did not gaze preferentially at erotic cues. For implicit appraisals, all groups demonstrated negative-neutral implicit associations with sexual words. For explicit appraisals, women with acquired SIAD reported more positive evaluations of sex relative to asexual individuals and women with lifelong SIAD. This project sheds light on key differences between asexuality and low desire, and has implications for best clinical practice guidelines for the assessment of lifelong SIAD.

Attention Bias and Recognition of Sexual Images

Attention to sexual stimuli is necessary for the development of sexual response, yet while there is some evidence of attention bias in favor of sexual stimuli, the direction and magnitude of the effect remain unknown. A high-powered sample of 113 participants was tested using the dot-probe task (DPT) and picture recognition task (PRT) to measure visuospatial attention to erotic images. Participants showed no attention bias in the DPT (r_B = 0.201, p = 0.064) but were significantly better at recognizing erotic rather than neutral or training pictures (d = 1.445 and 1.461, respectively, both p < 0.001). This indicates that spatial attention bias to sexual pictures is small, negligible, possibly even non-existent, or else the DPT is not a reliable tool to assess it. Results of the PRT, on the other hand, show that sexual stimuli are prioritized in memory and this should be explored in future research.

Gender Differences in the Relationship of Sexual Functioning with Implicit and Explicit Sex Liking and Sex Wanting: A Community Sample Study

The present study aimed to investigate associations of automatic and controlled cognition with sexual functioning, and moderation of these associations by working memory capacity in a community sample of heterosexual women (N = 65) and men (N = 51). Participants performed two single-target Implicit Association Tests (ST-IATs) to assess implicit liking and wanting of erotic stimuli. The Sexual Opinion Survey (SOS) was used to assess explicit liking of sex. The International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) were used to assess sexual function. Working memory capacity was assessed using the Towers of Hanoi task and mood using the Hospital Anxiety and Depression Scale (HADS). In female participants, higher levels of sexual functioning co-occurred with stronger implicit associations of erotic stimuli with wanting, whereas implicit sex liking was unrelated to level of sexual functioning. In male participants, higher levels of sexual functioning co-occurred with lower implicit liking of erotic stimuli, whereas implicit sex wanting was unrelated to sexual functioning. Higher erotophilia scores were related to higher levels of sexual functioning in both women and men, but anxiety and depression symptoms were unrelated to sexual functioning. Working memory capacity did not moderate the associations between erotophilia and sexual functioning.

Implicit Measures in Clinical Sex Research: A Critical Evaluation

INTRODUCTION

Current information-processing models of sexual arousal imply that both controlled and automatic affective-motivational processes are critically involved in sexual responding and suggest that dysfunctional automatic processes may be involved in the development and persistence of sexual dysfunctions. Because (dysfunctional) automatic processes and responses cannot be adequately captured by common self-report measures, implicit performance-based measures have been developed to index these processes.

OBJECTIVES

This review provides an overview of studies that used implicit tasks in clinical sexual research, and critically evaluates the contribution and promise of these measures to improve our understanding of the mechanisms involved in sexual dysfunctions.

METHODS

6 electronic main databases (AMED, MEDLINE, PsycArticles, Psychology & Behavioral Sciences Collection, PsycINFO, and SocINDEX) were searched for studies involving implicit measurement techniques to measure automatic processes in clinical sex research.

RESULTS

A series of studies examined if lowered (or heightened) attention for sex stimuli may be involved in low sexual arousal, low desire, and genital pain. Preliminary evidence showed that lowered attention is involved in low sexual arousal. The pattern with regard to desire and genital pain was mixed which may be due to heterogeneity in assessment instruments. A limited number of studies examined automatic memory associations with sexual cues. Preliminary evidence showed negative (sex-threat/sex-disgust) associations in women with genito-pelvic pain or penetration disorder, less positive associations in women with hypoactive sexual desire disorder, and sex-positive and sex-failure associations in men with sexual distress. Thus far, no studies have examined lowered (or heightened) automatic sexual approach tendencies related to sexual dysfunctions.

CONCLUSION

Implicit measures showed some promise as tools to index automatic sex-relevant cognitive mechanisms in sexual dysfunctions. Yet, more systematic research and the development of psychometrically sound measures are critical for a more comprehensive evaluation of the relevance of implicit measures in clinical sex research and their usefulness as indices of individual differences in clinical practice. Hinzmann J, Borg C, de Jong PJ. Implicit Measures in Clinical Sex Research: A Critical Evaluation. Sex Med Rev 2020;8:531-541.

To What Extent Do Erotic Images Elicit Visuospatial versus Cognitive Attentional Processes? Consistent Support for a (Non-Spatial) Sexual Content-Induced Delay

It is almost a cultural truism that erotic images attract our attention, presumably because paying attention to erotic stimuli provided our ancestors with mating benefits. Attention, however, can be narrowly defined as visuospatial attention (keeping such stimuli in view) or more broadly as cognitive attention (such stimuli taking up one's thoughts). We present four independent studies aiming to test the extent to which erotic images have priority in capturing visuospatial versus cognitive attention. Whereas the former would show in quicker reactions to stimuli presented in locations where erotic images appeared previously, the latter causes delayed responding after erotic images, independent of their location). To this end, we specifically modified spatial cueing tasks to disentangle visuospatial attention capture from general sexual content-induced delay (SCID) effects-a major drawback in the previous literature. Consistently across all studies (total N = 399), we found no evidence in support of visuospatial attention capture but reliably observed an unspecific delay of responding for trials in which erotic images appeared (irrespective of cue location). This SCID is equally large for heterosexual men and women and reliably associated with their self-reported sexual excitability.

Attentional bias toward and distractibility by sexual cues: A meta-analytic integration

From an evolutionary perspective, sexual stimuli are highly salient and are assumed to be processed with high priority. Hence, attentional processing of sexual cues is expected to not only bias attention but to also distract from other cognitive (foreground) tasks. It is, however, unclear to what extent these stimuli capture attention and whether there are differences between men and women. This meta-analysis combined the results of 32 studies employing experiments of attentional bias toward and distraction by sexual stimuli. From these, 13 studies provided data to examine gender differences. Overall, attentional bias and distractibility was lower than anticipated (g_z = 0.43, p < .001) and there was support for the assumption of higher attention bias/interference in men (g_s = 0.29, p = .031). Importantly, there was evidence for the presence of publication bias. With this in mind, findings are discussed in the context of stimulus features, the impact of provoked sexual arousal and motivational state, and gender-specific and -nonspecific neural processing of sexual stimuli which influence attention toward them.

Assessing Cognitive Appraisals Related to Sexual Function: A Scenario-Based Approach

Cognitive factors play an important role in the etiology and maintenance of sexual difficulties. To date, research has mostly relied on self-report measures to assess negative cognitions related to low sexual function. To overcome the limitations of self-report questionnaires, a series of open-ended, ambiguous sexual scenarios were developed and presented to participants (N = 600, M_age = 34.2 years), who were asked to generate an ending by entering a continuation for each scenario. Valence of completed scenarios was rated by the participants, and scenario endings were coded by two independent raters on three dimensions, namely reference to sexual problems, sexual communication, and the use of sexually explicit language. Sexual function was assessed with the Female Sexual Function Index and the International Index of Erectile Function. Multiple regression analyses were performed to assess whether the scenario-based task was associated with sexual function above and beyond other predictors (e.g., sexual distress). Individuals with lower sexual function rated the completed scenarios more negatively, and their endings included more references to problems related to low sexual function. In women with low sexual function, fewer endings included sexual communication with a partner or sexually explicit language. Our findings suggest that individuals with low sexual function appraise ambiguous sexual situations more negatively than other individuals. Future studies may investigate whether such biases can be experimentally manipulated and whether changes in cognitive biases may, in turn, lead to improvements in sexual function.

Implicit and Explicit Associations with Erotic Stimuli in Women with and Without Sexual Problems

Conceptual models of sexual functioning have suggested a major role for implicit cognitive processing in sexual functioning. The present study aimed to investigate implicit and explicit cognition in sexual functioning in women. Gynecological patients with (N = 38) and without self-reported sexual problems (N = 41) were compared. Participants performed two Single-Target Implicit Association Tests (ST-IAT), measuring the implicit association of visual erotic stimuli with attributes representing, respectively, valence and motivation. Participants also rated the erotic pictures that were shown in the ST-IATs on the dimensions of valence, attractiveness, and sexual excitement, to assess their explicit associations with these erotic stimuli. Participants completed the Female Sexual Functioning Index and the Female Sexual Distress Scale for continuous measures of sexual functioning, and the Hospital Anxiety and Depression Scale to assess depressive symptoms. Compared to nonsymptomatic women, women with sexual problems were found to show more negative implicit associations of erotic stimuli with wanting (implicit sexual motivation). Across both groups, stronger implicit associations of erotic stimuli with wanting predicted higher level of sexual functioning. More positive explicit ratings of erotic stimuli predicted lower level of sexual distress across both groups.

Gender Differences in Implicit Processing of Sexual Stimuli

The present studies investigated whether men and women differ in cognitive–motivational processing of sexual stimuli in order to better understand the commonly observed gender differences in sexual outcome variables. Because these processes often operate without conscious control, we focused specifically on automatic stimulus processing. Using a series of implicit tasks, we measured inhibition, attentional orientation, appraisal and approach–avoidance motivation regarding sexually explicit stimuli in male and female students. Results showed that men were more strongly motivated to approach sexual stimuli than women and were better able to inhibit sexual information as to prevent activation of the sexual response. With regard to attentional orientation, men were more easily drawn by sexual cues than women, yet only when the cues were presented long enough to allow more elaborative processing. No gender differences were found in the implicit evaluation of sexual information, although men and women did differ at the level of self–reported sexual evaluations. Our results indicate the importance of incorporating information–processing mechanisms and emotion regulation strategies into the conceptualization of the sexual response and promote further research on the specificity, robustness, predictive validity and malleability of the cognitive–motivational processes underlying sexual arousal. Copyright © 2015 European Association of Personality Psychology

Pedophilic brain potential responses to adult erotic stimuli

Cognitive mechanisms associated with the relative lack of sexual interest in adults by pedophiles are poorly understood and may benefit from investigations examining how the brain processes adult erotic stimuli. The current study used event-related brain potentials (ERP) to investigate the time course of the explicit processing of erotic, emotional, and neutral pictures in 22 pedophilic patients and 22 healthy controls. Consistent with previous studies, early latency anterior ERP components were highly selective for erotic pictures. Although the ERPs elicited by emotional stimuli were similar in patients and controls, an early frontal positive (P2) component starting as early as 185 ms was significantly attenuated and slow to onset in pedophilia, and correlated with a clinical measure of cognitive distortions. Failure of rapid attentional capture by erotic stimuli suggests a relative reduction in early processing in pedophilic patients which may be associated with relatively diminished sexual interest in adults.

Implicit and Explicit Sexual Attitudes: How Are They Related to Sexual Desire and Sexual Satisfaction in Men and Women?

This article examines individual variability in sexual desire and sexual satisfaction by exploring the relation between these sexual aspects and sexual attitudes (implicit and explicit) and by taking gender into account, as this has been shown to be an influential factor. A total of 28 men and 33 women living in heterosexual relationships completed questionnaires assessing sexual desire (dyadic, solitary), sexual satisfaction, and explicit sexual attitudes. An adapted version of the Affect Misattribution Procedure was used to assess implicit sexual attitudes. Results showed higher levels of dyadic and solitary sexual desire in men than in women. No gender differences were found regarding sexual satisfaction or sexual attitudes. High dyadic sexual desire was associated with positive implicit and explicit sexual attitudes, regardless of gender. However, solitary sexual desire was significantly higher in men than women and was associated, in women only, with positive implicit sexual attitudes, suggesting that solitary sexual desire may fulfill different functions in men and women. Finally, sexual satisfaction depended on the combination of explicit and implicit sexual attitudes in both men and women. This study highlights the importance of considering both implicit and explicit sexual attitudes to better understand the mechanisms underlying individual variability in sexual desire and satisfaction.

Disgust versus Lust: Exploring the Interactions of Disgust and Fear with Sexual Arousal in Women

Sexual arousal is a motivational state that moves humans toward situations that inherently pose a risk of disease transmission. Disgust is an emotion that adaptively moves humans away from such situations. Incongruent is the fact that sexual activity is elementary to human fitness yet involves strong disgust elicitors. Using an experimental paradigm, we investigated how these two states interact. Women (final N=76) were assigned to one of four conditions: rate disgust stimuli then watch a pornographic clip; watch a pornographic clip then rate disgust stimuli; rate fear stimuli then watch a pornographic clip; or watch a pornographic clip then rate fear stimuli. Women's genital sexual arousal was measured with vaginal photoplethysmography and their disgust and fear reactions were measured via self-report. We did not find that baseline disgust propensity predicted sexual arousal in women who were exposed to neutral stimuli before erotic content. In the Erotic-before-Disgust condition we did not find that sexual arousal straightforwardly predicted decreased image disgust ratings. However, we did find some evidence that sexual arousal increased self-reported disgust in women with high trait disgust and sexual arousal decreased self-reported disgust in women with low trait disgust. Women who were exposed to disgusting images before erotic content showed significantly less sexual arousal than women in the control condition or women exposed to fear-inducing images before erotic content. In the Disgust-before-Erotic condition the degree of self-reported disgust was negatively correlated with genital sexual arousal. Hence, in the conflict between the ultimate goals of reproduction and disease avoidance, cues of the presence of pathogens significantly reduce the motivation to engage in mating behaviors that, by their nature, entail a risk of pathogen transmission.

Implicit and Explicit Associations with Erotic Stimuli in Sexually Functional and Dysfunctional Men

INTRODUCTION

Although conceptual models of sexual functioning have suggested a major role for implicit cognitive processing in sexual functioning, this has thus far, only been investigated in women.

AIM

The aim of this study was to investigate the role of implicit cognition in sexual functioning in men.

METHODS

Men with (N = 29) and without sexual dysfunction (N = 31) were compared.

MAIN OUTCOME MEASURES

Participants performed two single-target implicit association tests (ST-IAT), measuring the implicit association of visual erotic stimuli with attributes representing, respectively, valence ('liking') and motivation ('wanting'). Participants also rated the erotic pictures that were shown in the ST-IAT on the dimensions of valence, attractiveness, and sexual excitement to assess their explicit associations with these erotic stimuli. Participants completed the International Index of Erectile Functioning for a continuous measure of sexual functioning.

RESULTS

Unexpectedly, compared with sexually functional men, sexually dysfunctional men were found to show stronger implicit associations of erotic stimuli with positive valence than with negative valence. Level of sexual functioning, however, was not predicted by explicit nor implicit associations. Level of sexual distress was predicted by explicit valence ratings, with positive ratings predicting higher levels of sexual distress.

CONCLUSIONS

Men with and without sexual dysfunction differed significantly with regard to implicit liking. Research recommendations and implications are discussed.

Perception of men's beauty and attractiveness by women with low sexual desire

INTRODUCTION

Despite the high prevalence of hypoactive sexual desire disorder (HSDD), especially among women, this sexual disorder remains poorly understood. Among the multiple factors possibly involved in HSDD, particularities in the cognitive evaluations of social stimuli need to be better characterized. Especially, beauty and attractiveness judgments, two dimensions of interpersonal perception that are related but differ on their underlying motivational aspects, may vary according to the level of sexual desire.

AIM

The main goal of this study was to investigate whether women with and without HSDD differ in their evaluations of beauty and attractiveness of men's faces and voices.

METHODS

Young women from the general population (controls, n = 16) and with HSDD (patients, n = 16) took part in the study. They were presented with a series of neutral/nonerotic voices and faces of young men from the GEneva Faces And Voices database.

MAIN OUTCOME MEASURES

Ratings of beauty (i.e., assessments of aesthetic pleasure) and of attractiveness (i.e., assessments of the personal propensity to feel attracted to someone) and the frequency to which the participants pressed a key to see or listen to each stimulus again were the main outcome measures.

RESULTS

Ratings of attractiveness were lower than ratings of beauty in both groups of women. The dissociation between beauty and attractiveness was larger in women with HSDD than in control participants. Patients gave lower attractiveness ratings than the controls and replayed the stimuli significantly less often.

CONCLUSION

These results suggest that women with HSDD are characterized by specific alterations of the motivational component of men's perception, very early in the process of interpersonal relationships. Our findings have significant implications, both in better understanding the specific cognitive processes underlying hypoactive sexual desire and more largely the evaluative processes involved in human mate choice.

Sex attracts: investigating individual differences in attentional bias to sexual stimuli

We investigated the impact of sexual stimuli and the influence of sexual motivation on the performance in a dot-probe task and a line-orientation task in a large sample of males and females. All pictures (neutral, erotic) were rated on the dimensions of valence, arousal, disgust, and sexual arousal. Additionally, questionnaires measuring sexual interest/desire/motivation were employed. The ratings of the sexual stimuli point to a successful picture selection because sexual arousal did not differ between the sexes. The stimuli were equally arousing for men and women. Higher scores in the employed questionnaires measuring sexual interest/desire/motivation led to higher sexual arousal ratings of the sex pictures. Attentional bias towards sex pictures was observed in both experimental tasks. The attentional biases measured by the dot-probe and the line-orientation task were moderately intercorrelated suggesting attentional bias as a possible marker for a sex-attention trait. Finally, only the sexual sensation seeking score correlated with the attentional biases of the two tasks. Future research is needed to increase the predictive power of these indirect measures of sexual interest.

The psychometric properties of the sexual excitation/sexual inhibition inventory for women (SESII-W) within a Dutch population

According to the dual control model, sexual arousal is dependent on the disposition for both sexual excitation (SE) and sexual inhibition (SI; Bancroft, 1999). Individual variability in sexual inhibition and sexual excitation could partly explain individual differences in sexual arousability and the likelihood of experiencing sexual problems (Bancroft, Graham, Janssen, & Sanders, 2009). The Sexual Excitation/Sexual Inhibition Inventory for Women (SESII-W) is a questionnaire developed to measure the factors sexual excitation and sexual inhibition (Graham, Sanders, & Milhausen, 2006). This study describes the validation of the Dutch version of the SESII-W in a sample of 445 women. Using confirmatory factor analysis, we determined that the eight lower-order factor model achieved adequate fit to the data. A decrement in fit was noted when the two higher-order factors SE and SI were included in the model. The measure demonstrated good construct validity, internal consistency, and test-retest reliability. Furthermore, the scores of women with sexual problems differed from those without sexual problems, providing evidence for the discriminant validity of the SESII-W.

Sexual desire, not hypersexuality, is related to neurophysiological responses elicited by sexual images

BACKGROUND

Modulation of sexual desires is, in some cases, necessary to avoid inappropriate or illegal sexual behavior (downregulation of sexual desire) or to engage with a romantic partner (upregulation of sexual desire). Some have suggested that those who have difficulty downregulating their sexual desires be diagnosed as having a sexual 'addiction'. This diagnosis is thought to be associated with sexual urges that feel out of control, high-frequency sexual behavior, consequences due to those behaviors, and poor ability to reduce those behaviors. However, such symptoms also may be better understood as a non-pathological variation of high sexual desire. Hypersexuals are thought to be relatively sexual reward sensitized, but also to have high exposure to visual sexual stimuli. Thus, the direction of neural responsivity to sexual stimuli expected was unclear. If these individuals exhibit habituation, their P300 amplitude to sexual stimuli should be diminished; if they merely have high sexual desire, their P300 amplitude to sexual stimuli should be increased. Neural responsivity to sexual stimuli in a sample of hypersexuals could differentiate these two competing explanations of symptoms.

METHODS

Fifty-two (13 female) individuals who self-identified as having problems regulating their viewing of visual sexual stimuli viewed emotional (pleasant sexual, pleasant-non-sexual, neutral, and unpleasant) photographs while electroencephalography was collected.

RESULTS

Larger P300 amplitude differences to pleasant sexual stimuli, relative to neutral stimuli, was negatively related to measures of sexual desire, but not related to measures of hypersexuality.

CONCLUSION

Implications for understanding hypersexuality as high desire, rather than disordered, are discussed.