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Lafortune D, Dubé S, Lapointe V, Bonneau J, Champoux C, Sigouin N. Virtual Reality Could Help Assess Sexual Aversion Disorder. JOURNAL OF SEX RESEARCH 2024; 61:588-602. [PMID: 37556729 DOI: 10.1080/00224499.2023.2241860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Virtual reality (VR) may improve our understanding of sexual dysfunctions' manifestations, although research in this area remains limited. This study assessed the potential use of a VR Behavior Avoidance Test (VR-BAT) as a tool for examining the clinical features of Sexual Aversion Disorder (SAD): the experience of fear, disgust, and avoidance when facing sexual cues/contexts. A sample of 55 adults (≥ 18y) with (n = 27) and without SAD (n = 28) completed a self-report measure of sexual avoidance. Their anxiety, disgust, electrodermal activity, heart rate, and visual and behavioral avoidance were then examined during two VR-BATs involving sexual or non-sexual stimuli. Mixed repeated measures ANOVAs, t-tests, and correlational analyses were performed. Results showed that individuals in the SAD group reported greater anxiety and disgust compared to their non-SAD counterparts during the sexual stimuli condition. Sexual avoidance scores were largely positively related to anxiety and disgust during the VR sexual condition, and moderately negatively related to the time spent touching the virtual character's genitals. This study is important given the prevalence of sexual difficulties, such as SAD, and the new research avenues offered by emerging technologies, like VR.
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Affiliation(s)
- D Lafortune
- Department of Sexology, Université du Québec à Montréal
| | - S Dubé
- Department of Psychology, Concordia University
| | - V Lapointe
- Department of Psychology, Université du Québec à Montréal
| | - J Bonneau
- School of Media, Université du Québec à Montréal
| | - C Champoux
- School of Media, Université du Québec à Montréal
| | - N Sigouin
- School of Media, Université du Québec à Montréal
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Mills-Finnerty C, Staggs H, Bittoni C, Wise N. Affective neuroscience: applications for sexual medicine research and clinical practice. Sex Med Rev 2024; 12:127-141. [PMID: 38281754 DOI: 10.1093/sxmrev/qead048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 10/03/2023] [Accepted: 10/26/2023] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Affective neuroscience is the study of the brain substrates of emotional, embodied experiences. Affective neuroscience theory (ANT) is based on experimental evidence that all mammals are hardwired with 7 primary subcortical emotional operating systems, or "core emotions," that have overlapping but distinct circuits buried in the deep, ancient parts of the brain. Imbalances in the 7 core emotions can affect multiple aspects of the individual's psychosocial well-being (eg, depression, anxiety, substance abuse). Here, we propose that core emotions can also influence sexual function and, specifically, that imbalances in core emotions are the bridge connecting psychiatric symptoms (eg, anhedonia) to sexual dysfunction (eg, anorgasmia). OBJECTIVES In this targeted review and commentary, we outline potential connections between ANT and sexual medicine research and clinical practice. We summarize ANT by defining the 3-level BrainMind and core emotions; examining how they relate to personality, behavior, and mental health; and determining the implications for sexual health research and clinical practice. METHODS A targeted literature review was conducted. Case studies were adapted from client files and clinician interviews and then anonymized. RESULTS We propose a novel organizational schema for implementing affective balance therapies for sexual dysfunction, which integrate psychoeducational, somatic, and cognitive therapeutic approaches under the ANT framework. We provide 3 patient case studies (anorgasmia, hypersexuality, spinal cord injury) outlining the implementation of this approach and patient outcomes. CONCLUSION ANT has practical translational applications in sexual health research and clinical practice. By integrating our understanding of the role of core emotions in human sexuality, clinicians can better tailor treatments to address sexual dysfunction.
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Affiliation(s)
- Colleen Mills-Finnerty
- Mental Illness Research, Education, and Clinical Care, Palo Alto Veterans Health Care System, Palo Alto, CA 94304, United States
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA 94304, United States
| | - Halee Staggs
- Mental Illness Research, Education, and Clinical Care, Palo Alto Veterans Health Care System, Palo Alto, CA 94304, United States
| | - Celeste Bittoni
- Department of Psychology, University of Padova, Padova 2 35122, Italy
| | - Nan Wise
- Department of Psychology, Rutgers University, Newark, NJ 07102, United States
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Brown NB, Milani S, Jabs F, Kingstone A, Brotto LA. Exploring Women's State-Level Anxiety in Response to Virtual Reality Erotica. JOURNAL OF SEX & MARITAL THERAPY 2023; 50:137-151. [PMID: 37807833 DOI: 10.1080/0092623x.2023.2265924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Virtual Reality (VR)-based treatments for anxiety disorders are efficacious but there is a lack of research examining anxious responses to VR erotica, which could innovate treatments for sexual difficulties. We examined erotica features that elicited anxiety and sexual presence in women. Thirty-eight women viewed erotic videos from different modalities (2D, VR) and points of view (1st, 3rd person) and completed anxiety and sexual presence measures before and after each video. Women experienced greater anxiety for VR than 2D films and reported the most anxiety for VR 1st person films. Sexual presence was affected by modality and point of view.
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Affiliation(s)
- Natalie B Brown
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Sonia Milani
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Faith Jabs
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Alan Kingstone
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Lori A Brotto
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, Canada
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Lafortune D, Dussault É, Vaillancourt-Morel MP, Lapointe VA, Blais M, Godbout N. Is Sexual Aversion a Distinct Disorder or a Trans-Diagnostic Symptom across Sexual Dysfunctions? A Latent Class Analysis. JOURNAL OF SEX & MARITAL THERAPY 2023; 50:105-120. [PMID: 37771315 DOI: 10.1080/0092623x.2023.2261933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
Sexual aversion disorder (SAD) is a chronic condition that impacts sexual and psychological well-being. However, the relevance of SAD as a discrete disorder remains highly debated. This study aimed to clarify the status of SAD as either a distinct disorder or a trans-diagnostic symptom shared among sexual dysfunctions. This cross-sectional study used a latent class analysis approach among a Canadian community sample (n = 1,363) to identify how patterns of SAD symptoms (i.e., sexual fear, disgust, and avoidance) emerge across different spheres of sexual functioning (i.e., desire and arousal, erection or lubrication, genito-pelvic pain, and orgasm) and examine sociodemographic and psychosexual correlates of the identified classes. Examination of fit indices suggested four classes: Sexually functional, Impaired desire and responsiveness, Sexual aversion, and Comorbid sexual dysfunctions. Sexual aversion class members were more likely to be single, had experienced sexual assault in adulthood, and report lower levels of sexual satisfaction and psychological well-being, compared to Sexually functional class members. Results suggest that SAD is a distinct clinical syndrome, while its symptoms may co-occur with other sexual dysfunctions. To ensure that the needs of people with SAD are met with tailored treatment options, future nosography might consider reclassifying SAD as a specific disorder.
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Affiliation(s)
- David Lafortune
- Department of Sexology, Université du Québec à Montréal, Montréal, Canada
| | - Éliane Dussault
- Department of Sexology, Université du Québec à Montréal, Montréal, Canada
| | | | - Valerie A Lapointe
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Martin Blais
- Department of Sexology, Université du Québec à Montréal, Montréal, Canada
| | - Natacha Godbout
- Department of Sexology, Université du Québec à Montréal, Montréal, Canada
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Prevalence and Correlates of Sexual Aversion: A Canadian Community-Based Study. J Sex Med 2022; 19:1269-1280. [DOI: 10.1016/j.jsxm.2022.05.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/17/2022] [Accepted: 05/23/2022] [Indexed: 11/20/2022]
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Lafortune D, Canivet C, Boislard MA, Godbout N. Validation of a brief French version of the sexual anxiety scale. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2021. [DOI: 10.3138/cjhs.2020-0042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Although sexual anxiety (SA) is associated with significant sexual and relationship difficulties, to date, we lack brief scales to adequately assess SA. The aim of the present study was to develop a brief and reliable French version of the Sexual Anxiety Scale (SAS) that can be used to screen the manifestations of SA and their severity. A community sample ( n = 576) was recruited to investigate the reliability and validity of the brief form of the scale (SAS-BF). Confirmatory factor analysis was performed on the original three-factor model (SAS) and on the new, four-factor SAS-BF. Its convergent validity was tested with theoretically relevant correlates (e.g., anxiety, sexual satisfaction). The SAS-BF yielded strong psychometric properties in terms of factor structure and reliability, and was reasonably correlated with associated variables. SAS-BF can be considered a valid short scale to assess SA in studies where a brief form of the questionnaire is desirable or during clinical screening with patients experiencing variable levels of SA.
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Affiliation(s)
- David Lafortune
- Département de sexologie, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Cloé Canivet
- Département de sexologie, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Marie-Aude Boislard
- Département de sexologie, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Natacha Godbout
- Département de sexologie, Université du Québec à Montréal, Montréal, Québec, Canada
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Stephenson KR. Exploring the Role of Sexual Avoidance in Male Sexual Dysfunction. JOURNAL OF SEX RESEARCH 2020; 57:522-533. [PMID: 31553241 DOI: 10.1080/00224499.2019.1663480] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Theoretical models of male sexual dysfunction highlight the role of sexual avoidance as a maintaining factor. However, little empirical research has directly tested the role of sexual avoidance in samples of men with sexual problems. The goals of the current study were to A) assess the association between sexual avoidance, sexual function, and subjective sexual well-being, and B) explore possible predictors of sexual avoidance, including insecure attachment, activation of negative sexual schemas, and trait experiential avoidance. One hundred and fifty eight men with self-identified impairments in sexual function (low desire, erectile function, and/or premature/delayed ejaculation) completed validated self-report measures in a secure online survey. Sexual avoidance was uniquely predicted by most aspects of sexual function, and was correlated with poorer subjective sexual well-being. Higher levels of attachment avoidance and activation of negative schemas uniquely predicted more frequent sexual avoidance. Alternatively, interaction models suggested that impaired erectile function was less likely to be associated with sexual avoidance for those with high levels of attachment anxiety and for those with high levels of trait experiential avoidance. Theoretical and practical implications are discussed.
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Panic Disorder Correlates With the Risk for Sexual Dysfunction. J Psychiatr Pract 2020; 26:185-200. [PMID: 32421290 DOI: 10.1097/pra.0000000000000460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Reports have suggested that sexual dysfunction is an underestimated complication of panic disorder, but little research has focused on sexual dysfunction associated specifically with panic disorder. The purpose of this systematic review was to investigate whether patients with panic disorder who are not currently receiving treatment had a higher risk of sexual dysfunction than healthy people, as well as to clarify the appropriate treatment for this patient group. METHODS Articles that reported panic disorder complicated with sexual dysfunction were identified by a systematic literature search of electronic databases, including PubMed, the Cochrane databases, EMBASE, and PsycINFO. RESULTS Six articles were included in the review. Patients with panic disorder showed a high prevalence of sexual aversion (35.7% to 64%) and sexual infrequency (36% to 44%). One cohort study indicated that untreated patients with panic disorders had a higher risk of erectile dysfunction than controls. Another article that focused specifically on female patients reported that the patients with panic disorder exhibited decreased frequency of sexual behavior and decreased sexual desire compared with the controls. However, 2 studies found conflicting results after adjustment for confounding factors. CONCLUSIONS Although the results were mixed, it appears that patients with panic disorder tended to be more susceptible to sexual dysfunction than the general population. Further trials with larger sample sizes and rigorous research designs are needed to establish the relationship between sexual dysfunction and panic disorder.
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Sexual Disgust: Evolutionary Perspectives and Relationship to Female Sexual Function. CURRENT SEXUAL HEALTH REPORTS 2019. [DOI: 10.1007/s11930-019-00219-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Lorenz TK. Interactions between inflammation and female sexual desire and arousal function. CURRENT SEXUAL HEALTH REPORTS 2019; 11:287-299. [PMID: 33312080 PMCID: PMC7731354 DOI: 10.1007/s11930-019-00218-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW To describe the current state of research on interactions between inflammation and female sexual function. RECENT FINDINGS Inflammation may interfere with female sexual desire and arousal via direct (neural) and indirect (endocrine, vascular, social/behavioral) pathways. There are significant sex differences in the effect of inflammation on sexual function, arising from different evolutionary selection pressures on regulation of reproduction. A variety of inflammation-related conditions are associated with risk of female sexual dysfunction, including cardiovascular disease, metabolic syndrome, and chronic pain. SUMMARY Clinical implications include the need for routine assessment for sexual dysfunction in patients with inflammation-related conditions, the potential for anti-inflammatory diets to improve sexual desire and arousal function, and consideration of chronic inflammation as moderator of sexual effects of hormonal treatments. Although the evidence points to a role for inflammation in the development and maintenance of female sexual dysfunction, the precise nature of these associations remains unclear.
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Affiliation(s)
- Tierney K Lorenz
- Department of Psychology and Center for Brain, Biology and Behavior, University of Nebraska at Lincoln
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