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Meyers M, Margraf J, Velten J. A Qualitative Study of Women's Experiences with Cognitive-Behavioral and Mindfulness-Based Online Interventions for Low Sexual Desire. JOURNAL OF SEX RESEARCH 2022; 59:1082-1091. [PMID: 35435791 DOI: 10.1080/00224499.2022.2056565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Cognitive-behavioral (CBT) and mindfulness-based therapy (MBT) are among the most researched types of psychological interventions for low sexual desire in women. While both have been found effective in improving women's sexual desire, little is known about how women personally experience these treatments. To closely examine both approaches from a participant's perspective, semi-structured telephone-based interviews were conducted with 51 cis-women (Mage = 39, SD = 11, range = 22 to 69) who participated in a randomized controlled study comparing internet-based CBT and MBT for low sexual desire with a waitlist. Interview data were analyzed using thematic and content analysis. Most women (n = 44, 86.3%) evaluated their respective treatment (i.e., CBT or MBT) as helpful in improving their sexual desire. CBT-techniques, such as cognitive restructuring, were mentioned as being helpful for challenging maladaptive thinking patterns, while formal mindfulness-exercises allowed women to disengage from negative sexuality-related thoughts. Elements of sex therapy, including self-stimulation exercises and sensate focus, were perceived as crucial for getting women in touch with their sexual desires and preferences. Strengths of the online format included anonymity, flexibility, and convenient access. Overall, women's personal accounts supported feasibility, acceptability, and clinical usefulness of CBT- and MBT-based internet interventions targeting low sexual desire.
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Affiliation(s)
- Milena Meyers
- Mental Health Research and Treatment Center, Clinical Psychology and Psychotherapy, Faculty of Psychology, Ruhr University Bochum
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Clinical Psychology and Psychotherapy, Faculty of Psychology, Ruhr University Bochum
| | - Julia Velten
- Mental Health Research and Treatment Center, Clinical Psychology and Psychotherapy, Faculty of Psychology, Ruhr University Bochum
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Clephane K, Wilson MC, Heiman JR, Craig AN, Lorenz T. Sexual violence history predicts changes in vaginal immune parameters during sexual arousal. Brain Behav Immun 2022; 104:171-180. [PMID: 35697156 PMCID: PMC9734281 DOI: 10.1016/j.bbi.2022.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/24/2022] [Accepted: 06/05/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To examine the influence of sexual arousal on vaginal mucosal inflammatory cytokine and antibody production in healthy women with and without histories of childhood and/or adult sexual violence. METHODS Ninety-one premenopausal healthy women (ages 18-42) attended a single laboratory session in which they provided vaginal fluid samples before and after viewing one neutral and one erotic film. While viewing the films, participants' vaginal sexual arousal was recorded using vaginal photoplethysmography. RESULTS Of the 91 participants, 41 (45%) reported no history of sexual violence, 17 (19%) reported a history of childhood sexual abuse (CSA) only, 19 (21%) reported a history of adult sexual assault (ASA) only, and 10 (11%) reported a history of both CSA and ASA, with 4 participants choosing not to provide information on their sexual violence history. For women with a history of ASA but not CSA, there was a significant increase in vaginal IL-1β following arousal, while for women with a history of CSA (with or without ASA), there was a significant decrease. Women without CSA histories had a significant increase in vaginal IgA following sexual arousal, while women with CSA histories had a decrease. CONCLUSION Sexual arousal possibly plays a role in modifying vaginal immune responses in young, healthy women. Moreover, these effects may vary depending upon sexual assault histories, such that relative to women without assault histories, women with a history of early life sexual trauma showed significantly altered vaginal immune responses following sexual arousal. If replicated, these findings may help explain the increased risk for sexually transmitted infections observed among women with sexual assault histories.
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Affiliation(s)
- Kirstin Clephane
- Department of Psychology, University of Nebraska-Lincoln, United States; Center for Brain, Biology & Behavior, University of Nebraska-Lincoln, United States
| | - M Claire Wilson
- Department of Psychological and Brain Sciences, Indiana University, United States
| | - Julia R Heiman
- Department of Psychological and Brain Sciences, Indiana University, United States
| | - Amber N Craig
- Medical College of Wisconsin, Department of Psychiatry and Behavioral Medicine, United States
| | - Tierney Lorenz
- Department of Psychology, University of Nebraska-Lincoln, United States; Center for Brain, Biology & Behavior, University of Nebraska-Lincoln, United States.
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Álvarez-Muelas A, Sierra JC, Gómez-Berrocal C, Arcos-Romero AI, Calvillo C, Granados R. Study of Sexual Concordance in Men and Women with Different Typologies of Adherence to the Sexual Double Standard. Int J Clin Health Psychol 2022; 22:100297. [PMID: 35281774 PMCID: PMC8873603 DOI: 10.1016/j.ijchp.2022.100297] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/31/2021] [Indexed: 11/27/2022] Open
Abstract
Background/Objective Sexual concordance (i.e., relationship between genital response and subjective sexual arousal) is higher in men than in women. Among the factors that could explain this difference would be the sexual double standard (SDS). Sexual concordance is examined by SDS typologies of adherence (egalitarian, man-favorable, and woman-favorable). Method During exposure to a film with sexual content, genital response (penile circumference/vaginal pulse amplitude) and self-reported sexual arousal were recorded in 104 young adults (42 men and 62 women), distributed into SDS typologies of adherence on the basis of their scores on the Sexual Double Standard Scale. Results Sexual concordance was obtained in men and women with egalitarian and man-favorable typology. Subjective sexual arousal explained a significant percentage of the variance in genital response in the egalitarian typology (men: R2 = .32, p < .01; women: R2 = .19, p < .05) and man-favorable typology (men: R2 = .21, p < .05; women: R2 = .23, p < .05). Conclusions Agreement between genital responsiveness and subjective sexual arousal depends on DES adherence typology.
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Lalumière ML, Sawatsky ML, Dawson SJ, Suschinsky KD. The Empirical Status of the Preparation Hypothesis: Explicating Women's Genital Responses to Sexual Stimuli in the Laboratory. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:709-728. [PMID: 32026221 DOI: 10.1007/s10508-019-01599-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/18/2019] [Accepted: 11/27/2019] [Indexed: 05/15/2023]
Abstract
Research conducted in our laboratory and in other laboratories has revealed that (1) women's genital responses to visual and auditory stimuli are strongly affected by the presence of sexual cues, but that (2) specific sexual cues (e.g., gender of actors, the presence of sexual violence) often have little impact on the magnitude of the responses-that is, similar genital responses are observed to very different sexual stimuli. In addition, (3) women's genital responses do not strongly correspond with self-reported sexual partner and activity preferences, or (4) with self-reported sexual arousal during the presentation of sexual stimuli. Taken together, these facts represent a puzzle, especially considering that men's genital responses are highly affected by specific sexual cues and strongly correspond to stated preferences and self-reported sexual arousal. One hypothesis to explain female low cue-specificity and low concordance (relative to men) is the preparation hypothesis: Women's indiscriminate genital responses serve a protective function. That is, they do not indicate or necessarily promote sexual interest and motivation, but rather prepare the vaginal lumen for possible sexual activity and therefore prevent injuries that may occur as a result of penetration. We review evidence for and against this hypothesis. We conclude that the evidence is favorable but not entirely convincing, and more work is required to reach a firm conclusion. We offer directions for future research.
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Affiliation(s)
- Martin L Lalumière
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada.
- The Royal's Institute of Mental Health Research, Ottawa, ON, Canada.
| | - Megan L Sawatsky
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada
| | - Samantha J Dawson
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Kelly D Suschinsky
- Substance Abuse and Concurrent Disorders Program, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
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Bickle A, Cameron C, Hassan T, Safdar H, Khalifa N. International overview of phallometric testing for sexual offending behaviour and sexual risk. BJPsych Int 2021; 18:E11. [PMID: 34747938 PMCID: PMC8554943 DOI: 10.1192/bji.2021.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 12/28/2020] [Accepted: 04/12/2021] [Indexed: 11/23/2022] Open
Abstract
Phallometry is an objective method of assessing male sexual arousal. The main applications in forensic psychiatry concern the evaluation of men charged with or convicted of sexual offences, the evaluation of those with suspected paraphilias not subject to the criminal justice system, risk assessment and measurement of response to sex offender treatment. In some jurisdictions, phallometry is incorporated into legal decisions about release from custody or discharge from secure hospitals. This paper provides a brief overview of the international development of phallometry, considers challenges to its broader adoption and discusses future directions for research and clinical practice.
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Affiliation(s)
- Andrew Bickle
- Assistant Professor in Forensic Psychiatry, Department of Psychiatry, Queen's University, Kingston, Canada,
| | - Colin Cameron
- National Senior Psychiatrist, Correctional Service Canada/Government of Canada
| | - Tariq Hassan
- Associate Professor in Forensic Psychiatry, Department of Psychiatry, Queen's University, Kingston, Canada
| | - Hira Safdar
- Assistant Professor, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Najat Khalifa
- Associate Professor in Forensic Psychiatry, Queen's University, Department of Psychiatry, Kingston, Canada
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Sawatsky ML, Suschinsky KD, Lavrinsek S, Chivers ML, Lalumière ML. Can the Vaginal Photoplethysmograph and Its Associated Methodology Be Used to Assess Anal Vasocongestion in Women and Men? ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:3865-3888. [PMID: 34145487 DOI: 10.1007/s10508-021-02069-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 06/12/2023]
Abstract
Forty years ago, researchers documented changes in vascular and muscular activity within the anal canal of women and men who engaged in sexual self-stimulation. Vascular changes were assessed using a photoplethysmograph that aimed to detect changes in pelvic vasocongestion. An important advantage of detecting sexual response within the anal canal is that the device, its anatomical placement, and the data output are identical for women and men, therefore facilitating gender comparisons of response patterns. In this study, the vaginal photoplethysmograph (VPP), the most common measure of genital response in women, was administered intra-anally as an anal photoplethysmograph (APG) to examine its validity and sensitivity as an indicator of sexual response. The final sample comprised 20 women and 20 men who were exposed to 12, 90-s sexual and nonsexual film clips while their APG responses were recorded. Participants also rated their sexual arousal and affective responses to the stimuli. There was evidence that APG responses were specific to sexual stimuli and were sensitive to erotic intensity in women. The degree of discrimination between sexual and nonsexual stimuli was lower in men. Unlike most sexual psychophysiological studies, the positive correlation between physiological and self-reported sexual arousal was stronger in women than in men. There was a relatively high number of data artifacts and the waveform morphology was uncharacteristic of that typically observed with VPP. The potential role of anal musculature interference on the APG signal is discussed, as well as avenues for future research.
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Affiliation(s)
- Megan L Sawatsky
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada
| | | | - Sofija Lavrinsek
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | | | - Martin L Lalumière
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1N 6N5, Canada.
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Clephane K, Wilson MC, Craig AN, Heiman JR, Lorenz TK. Inflammation predicts sexual arousability in healthy women. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 8. [PMID: 35669911 PMCID: PMC9165647 DOI: 10.1016/j.cpnec.2021.100086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Though many women report sexual arousal difficulties, the mechanisms driving these difficulties are unclear. Sexual response relies on a host of psychophysiological processes that have bidirectional relationships with inflammation. Additionally, chronic inflammation may impair genital blood flow, which in turn may impact sexual arousal. C-reactive protein (CRP) is an acute-phase marker of inflammation produced in response to cytokine signaling throughout the body, which makes it a useful marker of systemic inflammation. Aim The present study examined interactions between inflammation and women's sexual arousal. Methods CRP, self-reported frequency of partnered sexual activity, and subjective and vaginal arousal were assessed in 91 healthy, pre-menopausal women. Data were collected during a single laboratory session. Main outcome measures Subjective sexual arousal and vaginal pulse amplitude (a measure of vaginal arousal) were the main outcome measures. Results Change in subjective sexual arousal in response to a sexual film was unaffected by baseline CRP and sexual frequency. However, there were significant interactions between inflammation and sexual frequency in predicting vaginal arousal during the sexual film. Among women reporting more frequent sexual activity, higher CRP predicted lower magnitude arousal response and longer time to maximum vaginal arousal. Among women reporting less frequent sex, higher CRP predicted shorter time to maximum arousal and greater magnitude of arousal response. Controlling for cortisol strengthened the effects seen for time to maximum vaginal arousal but weakened those observed for percent change. Conclusions Among healthy young women, higher CRP may be associated with vaginal arousal, but not subjective sexual arousal. Specifically, our results suggest that higher baseline CRP is associated with lower genital sexual arousal for women who have sex frequently, which is consistent with clinical evidence that elevated inflammation can be detrimental to sexual function. Among healthy young women, higher CRP may be associated with vaginal sexual arousal, but not subjective sexual arousal. Frequency of sexual activity interacts with CRP levels to contribute to vaginal arousal in healthy women. Higher CRP predicted lower genital sexual arousal in women who engage in sexual activity more than once a week. However, higher CRP predicted greater genital sexual arousal in women who engage in sexual activity less than once a week.
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Sawatsky ML, Lalumière ML. Effect of a Condom Cover on Vaginal Photoplethysmographic Responses. J Sex Med 2020; 17:702-715. [PMID: 32035833 DOI: 10.1016/j.jsxm.2019.12.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/28/2019] [Accepted: 12/13/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The vaginal photoplethysmograph (VPP) is a reusable intravaginal device often employed in sexual psychophysiology studies to assess changes in vaginal blood flow, an indicator of sexual arousal. AIM To test whether placing a disposable cover on the VPP probe impacts the acquired data. A condom cover would reduce risk of disease transmission and likely increase participant comfort but may negatively impact the VPP signal. METHOD The genital responses of 25 cisgender women (mean age = 21.3 years, standard deviation = 2.6) were assessed with VPP in a within-subjects design with 2 conditions-with and without a polyisoprene condom cover. Sexual responses were elicited by audiovisual film clips that varied in erotic intensity: nonsexual (nonsexual male-female interaction), low-intensity sexual (nude exercise), and high-intensity sexual (male-female intercourse). Women continuously rated their sexual arousal during stimulus presentations. MAIN OUTCOME MEASURE Change in vaginal pulse amplitude and also self-reported sexual arousal. RESULTS The magnitude of sexual response to each stimulus category and the overall pattern of results were found to be highly similar in the cover-off and cover-on conditions. The high-intensity sexual stimulus category elicited a greater sexual response than all other categories. The low-intensity sexual category elicited a (small) genital response in only the cover-on condition, although we suspect this is a spurious finding. There was no difference in the average number of edited movement artifacts across conditions. CLINICAL IMPLICATIONS Potential benefits of encasing the VPP probe with a protective cover include enhanced participant safety and comfort, especially if assessing genital responses of high-risk or immunocompromised samples. The use of a cover complies with current guidelines for reprocessing semi-critical medical devices (eg, vaginal ultrasound probes) in many regions. STRENGTHS & LIMITATIONS Although the idea of a VPP probe cover had been discussed among sexual psychophysiology researchers, this is the first study to empirically test whether a cover could jeopardize VPP data. Potential limitations include the use of a 10-Hz VPP sampling rate and a cover that was not tailored to the size of the VPP probe. CONCLUSION Placing a protective cover on the VPP probe did not appear to meaningfully impact sexual arousal or the VPP data. Based on these results and the potential advantages of a protective cover, researchers may wish to integrate the use a condom cover in their experiment protocols and clinical applications. Sawatsky ML, Lalumière ML. Effect of a Condom Cover on Vaginal Photoplethysmographic Responses. J Sex Med 2020; 17:702-715.
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Affiliation(s)
- Megan L Sawatsky
- University of Ottawa, Faculty of Social Sciences, Department of Psychology, Ottawa, ON, Canada
| | - Martin L Lalumière
- University of Ottawa, Faculty of Social Sciences, Department of Psychology, Ottawa, ON, Canada.
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Laser Doppler Imaging as a Measure of Female Sexual Arousal: Further Validation and Methodological Considerations. Biol Psychol 2019; 148:107741. [PMID: 31425725 DOI: 10.1016/j.biopsycho.2019.107741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 07/07/2019] [Accepted: 08/12/2019] [Indexed: 11/21/2022]
Abstract
Laser Doppler imaging has recently been applied to the study of female sexual response, with promising results. The current study sought to provide further validation for its use in this capacity, as well as to examine the sexual psychophysiological concepts of genital non-response and return to baseline with this instrument. A sample of healthy heterosexual women without any sexual concerns (N = 24) participated in a single testing session design, which included self-report measures and genital imaging with the laser Doppler imager (LDI). During the imaging portion of the study, genital and subjective arousal data were collected while participants watched neutral and erotic film stimuli. The results support the validity of the LDI as a measure of female sexual arousal, and highlight its potential utility in research and clinical applications for sexual function and related difficulties.
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Toward a More Evidence-Based Nosology and Nomenclature for Female Sexual Dysfunctions—Part III. J Sex Med 2019; 16:452-462. [DOI: 10.1016/j.jsxm.2019.01.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 01/04/2019] [Accepted: 01/10/2019] [Indexed: 11/23/2022]
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