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Maseroli E, Cipriani S, Lanzi V, Ravelli SA, Annunziato M, Alfaroli C, Lippi D, Cirillo M, Castellini G, Giraldi A, Maggi M, Vignozzi L. Hypoactive sexual desire disorder in women: new possibilities to ensure better understanding, diagnosis, and response to treatment. J Sex Med 2024; 21:861-871. [PMID: 39222959 DOI: 10.1093/jsxmed/qdae102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 07/05/2024] [Accepted: 07/30/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Hypoactive Sexual Desire Disorder (HSDD) is a frequent sex-related problem in women; however, a specific tool to characterize HSDD subtypes based on sexual inhibitory and excitatory factors is still lacking. AIM (1) To find a cutoff value in Sexual Inhibition Scale (SIS)/Sexual Excitation Scale (SES) scores predicting a diagnosis of HSDD in women consulting for sexual symptoms, (2) to explore the sexual inhibitory and excitatory profiles in women referred to a clinic for female sexual dysfunction by stratifying the sample according to the newfound cutoffs, and (3) to identify biopsychosocial factors significantly associated with the 2 profiles. METHODS An overall 133 women consulting for sexual symptoms were retrospectively evaluated for clinical, biochemical, and psychosexologic data collected at the first visit. A subgroup of 55 women treated with transdermal testosterone was retrospectively analyzed at baseline and the 6-month visit. OUTCOMES Patients underwent physical and laboratory examinations and completed the SIS/SES, Female Sexual Function Index, Female Sexual Distress Scale-Revised, Emotional Eating Scale, and Middlesex Hospital Questionnaire. RESULTS Specific cutoffs for SIS1 (≥32.5; indicating threat of performance failure) and SES (≤46.5) predicted HSDD diagnosis with an accuracy of 66.4% (P = .002) and 68.7% (P < .0001), respectively. Patients with impaired SIS1 scores showed higher distress and psychopathologic symptoms, while those with impaired SES scores demonstrated lower desire and arousal and a negative association with some metabolic and hormonal parameters. SES score also showed a significant predictive value on testosterone treatment efficacy for HSDD. CLINICAL TRANSLATION A better characterization of HSDD would enable individualized treatment based on the main underlying etiologies. STRENGTHS AND LIMITATIONS Limitations of the study include the small sample size and cross-sectional retrospective design, with the choice of treatment for HSDD limited to transdermal testosterone. Strengths comprise the thorough and multifactorial evaluation of every aspect potentially affecting inhibitory and excitatory components of sexual desire. CONCLUSION Validated cutoffs of SIS/SES scores could allow deep characterization of women diagnosed with HSDD, thus ensuring better tailoring of therapy and prediction of the probability of response to specific treatments.
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Affiliation(s)
- Elisa Maseroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi University Hospital, Florence, 50139, Italy
| | - Sarah Cipriani
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi University Hospital, Florence, 50139, Italy
- Department of Experimental, Clinical and Biomedical Sciences "Mario Serio," University of Florence, Florence, 50139, Italy
- Aware Fertility Unit, AUSL Toscana Centro, Florence, 50121, Italy
- Center for the Prevention, Diagnosis and Treatment of Infertility, Careggi University Hospital, Florence, 50134, Italy
| | - Valeria Lanzi
- Endocrinology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, 20122, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, 20157, Italy
| | - Serena Anna Ravelli
- Department of Experimental, Clinical and Biomedical Sciences "Mario Serio," University of Florence, Florence, 50139, Italy
| | - Mattia Annunziato
- Department of Experimental, Clinical and Biomedical Sciences "Mario Serio," University of Florence, Florence, 50139, Italy
| | - Chiara Alfaroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi University Hospital, Florence, 50139, Italy
- Department of Experimental, Clinical and Biomedical Sciences "Mario Serio," University of Florence, Florence, 50139, Italy
| | - Donatella Lippi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, 50134, Italy
| | - Michela Cirillo
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi University Hospital, Florence, 50139, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, 50134, Italy
| | - Giovanni Castellini
- Psychiatric Unit, Department of Health Sciences, University of Florence, Florence, 50134, Italy
| | - Annamaria Giraldi
- Sexological Clinic, Mental Health Center Copenhagen, Copenhagen University Hospital-Mental Health Services CPH, Copenhagen, 2200, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, 2200, Denmark
| | - Mario Maggi
- Department of Experimental, Clinical and Biomedical Sciences "Mario Serio," University of Florence, Florence, 50139, Italy
- Endocrinology Unit, Careggi University Hospital, Florence, 50134, Italy
- INBB (Istituto Nazionale Biostrutture e Biosistemi), Rome, 00136, Italy
| | - Linda Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi University Hospital, Florence, 50139, Italy
- Department of Experimental, Clinical and Biomedical Sciences "Mario Serio," University of Florence, Florence, 50139, Italy
- Center for the Prevention, Diagnosis and Treatment of Infertility, Careggi University Hospital, Florence, 50134, Italy
- INBB (Istituto Nazionale Biostrutture e Biosistemi), Rome, 00136, Italy
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Leonid K. Exploring the relationship between temporomandibular disorders and sexual function. Sex Med Rev 2024:qeae063. [PMID: 39237359 DOI: 10.1093/sxmrev/qeae063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 08/02/2024] [Accepted: 08/08/2024] [Indexed: 09/07/2024]
Abstract
INTRODUCTION Temporomandibular disorders (TMDs) encompass various conditions affecting the temporomandibular joint and surrounding structures, often presenting with pain, limited movement, and functional impairments. TMDs may affect kissing and oral sex, in addition to influencing sexual function, as any other chronic pain condition. OBJECTIVE The study sought to examine the connection between TMDs and sexual function. METHODS A literature review was conducted, synthesizing evidence from various disciplines, including dentistry, physical therapy, psychology, and sexual medicine. Relevant studies were analyzed to elucidate the multifaceted nature of TMDs and their potential impact on sexual health. RESULTS Emerging evidence suggests a complex relationship between TMDs and sexual function, with chronic pain, psychological distress, and physiological factors potentially contributing to sexual dysfunction. CONCLUSION Understanding the interconnectedness of TMDs and sexual function is essential for providing comprehensive care. Further research is needed to assess the association between TMDs and sexual dysfunction, elucidate the underlying mechanisms, and develop targeted interventions that address both TMD symptoms and sexual health concerns.
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Affiliation(s)
- Kalichman Leonid
- Department of Physical Therapy, Ben Gurion University of the Negev, Beer Sheva, Israel
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Frérart L, De Roovere C, Sels L, Ceulemans E, Janssen E, Kuppens P. In the Mood: How Sexual Desire Predicts and is Predicted by Romantic Partners' Mood. JOURNAL OF SEX RESEARCH 2024:1-11. [PMID: 39231096 DOI: 10.1080/00224499.2024.2395482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/06/2024]
Abstract
The association between mood and sexual desire has been the object of significant scientific and public interest. How mood shapes and is shaped by sexual desire is typically studied within one and the same individual, yet sexual desire is often experienced in the context of a romantic relationship. To obtain a more complete picture of the relation between mood and sexual desire, we examined the temporal interplay between mood and sexual desire both within and between partners in a romantic relationship. Using data from an experience sampling study involving both partners of mixed-gender romantic couples (N = 188; Mage = 26.34, SDage = 5.33), we investigated how each partner's mood (in terms of positive and negative affect) predicted their own sexual desire as well as that of their partner and vice versa. Results of both concurrent and temporal analyses confirmed bidirectional associations between mood and sexual desire both within and between partners, such that (1) both a person's own and their partner's positive mood predicted an increase in sexual desire, and a person's own and their partner's negative mood predicted a decrease in sexual desire. In addition, (2) both a person's own and their partner's sexual desire predicted an increase in positive mood, and a person's own and their partner's sexual desire predicted a decrease in negative mood. Only a few gender differences were found. The results underscore how sexual desire can predict and be predicted by both romantic partners' mood, highlighting the need for interactional models of sexual desire.
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Affiliation(s)
- Liesse Frérart
- Faculty of Psychology and Educational Sciences, KU Leuven
| | | | - Laura Sels
- Faculty of Psychology and Educational Sciences, Ghent University
| | - Eva Ceulemans
- Faculty of Psychology and Educational Sciences, KU Leuven
| | - Erick Janssen
- Institute for Family and Sexuality Studies, KU Leuven
| | - Peter Kuppens
- Faculty of Psychology and Educational Sciences, KU Leuven
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Sánchez-Fuentes MDM, Álvarez-Muelas A, Cervilla O, Granados R, Sierra JC. Sexual Excitation in Young Women with Different Levels of Sexual Satisfaction in Relationships: A Laboratory Study. Behav Sci (Basel) 2024; 14:769. [PMID: 39335985 PMCID: PMC11428973 DOI: 10.3390/bs14090769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 08/28/2024] [Accepted: 08/29/2024] [Indexed: 09/30/2024] Open
Abstract
Sexual satisfaction is an important dimension of sexual health. Despite there being evidence about its relations with sexual arousal, this association has not been addressed considering arousal as a trait and as a state. Therefore, the goal of this laboratory study was to examine, in young women with different levels of sexual satisfaction in their relationships, sexual arousal as a trait (i.e., propensity for sexual excitation/inhibition) and as a state (i.e., genital response and self-reported sexual arousal to a video with explicit sexual content). The sample was composed of 45 Spanish heterosexual women with a partner, from 18 to 25 years old. In the first phase, we evaluated the propensity for sexual inhibition/excitation and sexual satisfaction of the participants. In the second phase-in the context of a sexuality laboratory-the vaginal pulse amplitude, the rating of sexual arousal, and the rating of genital sensations were evaluated. The participants, distributed in three groups with different levels of sexual satisfaction (p < 0.001), were compared based on the different measures of sexual arousal. The results indicated that the group with lower sexual satisfaction, compared to the group with higher sexual satisfaction, reported more sexual inhibition due to the threat of performance failure (p = 0.011) and due to the threat of performance consequences (p = 0.038). However, no significant differences in sexual arousal status were found between the three groups. In conclusion, the negative association between sexual satisfaction and propensity for sexual inhibition in young women with a partner is supported, but not the positive association between trait/state sexual arousal and sexual satisfaction.
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Affiliation(s)
- María del Mar Sánchez-Fuentes
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain; (M.d.M.S.-F.); (A.Á.-M.); (O.C.)
| | - Ana Álvarez-Muelas
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain; (M.d.M.S.-F.); (A.Á.-M.); (O.C.)
| | - Oscar Cervilla
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain; (M.d.M.S.-F.); (A.Á.-M.); (O.C.)
| | - Reina Granados
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain;
| | - Juan Carlos Sierra
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain; (M.d.M.S.-F.); (A.Á.-M.); (O.C.)
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Briken P, Bőthe B, Carvalho J, Coleman E, Giraldi A, Kraus SW, Lew-Starowicz M, Pfaus JG. Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective. Sex Med Rev 2024; 12:355-370. [PMID: 38529667 PMCID: PMC11214846 DOI: 10.1093/sxmrev/qeae014] [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: 11/19/2023] [Revised: 02/02/2024] [Accepted: 02/03/2024] [Indexed: 03/27/2024]
Abstract
INTRODUCTION The addition of compulsive sexual behavior disorder (CSBD) into the ICD-11 chapter on mental, behavioral, or neurodevelopmental disorders has greatly stimulated research and controversy around compulsive sexual behavior, or what has been termed "hypersexual disorder," "sexual addiction," "porn addiction," "sexual compulsivity," and "out-of-control sexual behavior." OBJECTIVES To identify where concerns exist from the perspective of sexual medicine and what can be done to resolve them. METHODS A scientific review committee convened by the International Society for Sexual Medicine reviewed pertinent literature and discussed clinical research and experience related to CSBD diagnoses and misdiagnoses, pathologizing nonheteronormative sexual behavior, basic research on potential underlying causes of CSBD, its relationship to paraphilic disorder, and its potential sexual health consequences. The panel used a modified Delphi method to reach consensus on these issues. RESULTS CSBD was differentiated from other sexual activity on the basis of the ICD-11 diagnostic criteria, and issues regarding sexual medicine and sexual health were identified. Concerns were raised about self-labeling processes, attitudes hostile to sexual pleasure, pathologizing of nonheteronormative sexual behavior and high sexual desire, mixing of normative attitudes with clinical distress, and the belief that masturbation and pornography use represent "unhealthy" sexual behavior. A guide to CSBD case formulation and care/treatment recommendations was proposed. CONCLUSIONS Clinical sexologic and sexual medicine expertise for the diagnosis and treatment of CSBD in the psychiatric-psychotherapeutic context is imperative to differentiate and understand the determinants and impact of CSBD and related "out-of-control sexual behaviors" on mental and sexual well-being, to detect forensically relevant and nonrelevant forms, and to refine best practices in care and treatment. Evidence-based, sexual medicine-informed therapies should be offered to achieve a positive and respectful approach to sexuality and the possibility of having pleasurable and safe sexual experiences.
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Affiliation(s)
- Peer Briken
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Center, Hamburg-Eppendorf, Hamburg 20251, Germany
| | - Beáta Bőthe
- Department of Psychology, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre de Recherche Interdisciplinaire Sur Les Problèmes Conjugaux Et Les Agressions Sexuelles, Montréal, QC H3C 3J7, Canada
| | - Joana Carvalho
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro 3810-193, Portugal
| | - Eli Coleman
- Eli Coleman Institute for Sexual and Gender Health, University of Minnesota, Minneapolis, MN 55454, United States
| | - Annamaria Giraldi
- Sexological Clinic, Mental Health Center, Copenhagen University Hospital, Mental Health Services, Copenhagen CPH 2200, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
| | - Shane W Kraus
- Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV 5030, United States
| | - Michał Lew-Starowicz
- Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw 01-809, Poland
| | - James G Pfaus
- Center for Sexual Health and Intervention, Czech National Institute of Mental Health, Klecany 25067, Czech Republic
- Department of Psychology and Life Sciences, Faculty of Humanities, Charles University, Prague 18200, Czech Republic
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Semenyna SW, Vasey PL, Honey PL. Sex and Sexual Orientation Differences in Dark Triad Traits, Sexual Excitation/Inhibition, and Sociosexuality. ARCHIVES OF SEXUAL BEHAVIOR 2024:10.1007/s10508-024-02895-5. [PMID: 38890227 DOI: 10.1007/s10508-024-02895-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 06/20/2024]
Abstract
The present study sought to investigate sex and sexual orientation differences in several traits related to sexuality and sexual behavior. Examining sexual orientation differences alongside basic sex differences to help identify correlates of sexual orientation diversity, and whether individuals with varying degrees of same-sex attraction show concurrent sex-atypical shifts in other domains. Males tend to score higher than females in the Dark Triad (DT) traits of sub-clinical narcissism, psychopathy, and Machiavellianism. Similarly, females tend to be more cautious than males in their attitudes and desires toward casual sex activity (i.e., sociosexuality). These sex differences may be related to the propensity for individuals to become easily sexually excited, which is higher in males, or to instead inhibit sexual arousal, which is higher in females. In a large undergraduate sample (N = 2047), we replicated expected sex differences in DT traits, sociosexuality, and sexual excitation/inhibition. We found that non-heterosexual females were "male-shifted" in some of these traits, but these shifts tended to be strongest among mostly heterosexual and bisexual individuals. Furthermore, we found that within-sex variation in sociosexuality, sexual excitation, and sexual inhibition was not related to sexual orientation in a linear fashion. Instead, sociosexuality and sexual excitation were related to sexual orientation in a curvilinear (inverted-U) fashion, especially among females. The fact that traits correlated with bisexuality and homosexuality were somewhat distinct is consistent with the idea that different developmental pathways may lead to these discrete sexual attraction patterns.
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Affiliation(s)
- Scott W Semenyna
- Department of Psychology, MacEwan University, City Centre Campus, 10700 104 Avenue, Edmonton, AB, T5J 4S2, Canada.
| | - Paul L Vasey
- Department of Psychology, University of Lethbridge, Lethbridge, AB, Canada
| | - P Lynne Honey
- Department of Psychology, MacEwan University, City Centre Campus, 10700 104 Avenue, Edmonton, AB, T5J 4S2, Canada
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Lehmann RJB, Schäfer T, Bartels R, Sabic S, Schache C. Testing the Factor Structure and Construct Validity of the German Version of Gray et al.'s (2003) Sexual Fantasy Questionnaire. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:2225-2236. [PMID: 38514494 PMCID: PMC11176224 DOI: 10.1007/s10508-024-02831-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 03/23/2024]
Abstract
Gray et al.'s (2003) Sexual Fantasy Questionnaire (SFQ) is becoming an increasingly used self-report measure of sexual fantasy use. The current study analyzed the factorial structure and construct validity of the behavioral items of the SFQ using a nomological network of other sexuality-related measures in a large German-speaking sample (N = 846). Participants' (27.7% females) mean age was 30.8 years (SD = 11.0). Exploratory factor analysis revealed a 65-item scale comprising five-factors, which were termed: normophilic sexual fantasies, sexualized aggression, sexualized submission, submissive courtship, and bodily functions. This German version of the SFQ was found to have high construct validity indicated by its association with other related constructs. Based on these results, we argue that the SFQ is a valid self-report measure that can be used in both research and clinical practice (foremost the factors sexualized aggression and sexualized submission). Suggestions for future research are discussed in light of the results and the study's limitations.
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Affiliation(s)
- Robert J B Lehmann
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Straße 50, 14197, Berlin, Germany.
| | - Thomas Schäfer
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Straße 50, 14197, Berlin, Germany
| | - Ross Bartels
- School of Psychology, University of Lincoln, Lincoln, UK
| | - Sabina Sabic
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Straße 50, 14197, Berlin, Germany
| | - Catrin Schache
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Straße 50, 14197, Berlin, Germany
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Kolena B, Hlisníková H, Nagyová M, Orendáčová K, Vondráková M, Petrovičová I, Mlynček M, Weiss P, Pfaus JG. Endocrine effect of phthalate metabolites and a butterfly effect of prenatal exposure to androgens on qualitative aspects of female sexual response- an initial survey. Int J Impot Res 2024:10.1038/s41443-024-00919-1. [PMID: 38806628 DOI: 10.1038/s41443-024-00919-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 05/10/2024] [Accepted: 05/16/2024] [Indexed: 05/30/2024]
Abstract
There is growing evidence that endocrine disruptive chemicals have deleterious effects on sexual and reproductive function. To examine subjective sexual functions in human females and their relationship to postnatal phthalate exposure and perinatal androgenization, a Sexuality Score (SS) was established from a first-stage survey questionnaire of subjective sexual function filled out by female university students (n = 68; average age 25.23 ± 5.17 years; rural 25.51 ± 6.74 vs. urban 25.85 ± 1.43 years). Seventeen phthalate metabolites in urine samples were analyzed by high-performance liquid chromatography (HPLC) and tandem mass spectrometry (MS/MS). Females were also assessed for the 2D:4D digit ratio as an index of perinatal androgenization. The mean age of menarche was 12.82 ± 1.35 years (rural 12.59 ± 1.39 vs. urban 13.18 ± 1.27; p = 0.01). The mean age at first sexual intercourse was 14.88 ± 6.89 years (rural 14.62 ± 7.20 vs. urban 15.24 ± 6.55), and as the age of first sexual intercourse increases, the SS score tends to increase as well, albeit moderately (r = 0.25, p = 0.037). Mono-iso-butyl phthalate, mono(2-ethyl-5-carboxypentyl) phthalate, mono(hydroxy-n-butyl) phthalate, mono(2-ethyl-5-oxohexyl) phthalate (p ≤ 0.05) and mono(2-carboxymethylhexyl) phthalate (p ≤ 0.01) were negatively associated with SS. A compounding butterfly effect of prenatal exposure to androgens was observed with disruptive effects of mono(2-ethyl-5-oxohexyl) phthalate and mono(2-ethyl-5-carboxypentyl) phthalate on sexual function. Exposure to phthalates in adult females may lead to disruption of subjective sexual function, especially concerning sexual desire and sexual satisfaction, and perinatal androgenization could augment these effects.
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Affiliation(s)
- Branislav Kolena
- Department of Zoology and Anthropology, Constantine the Philosopher University, Nitra, Slovakia.
| | - Henrieta Hlisníková
- Department of Zoology and Anthropology, Constantine the Philosopher University, Nitra, Slovakia
| | - Miroslava Nagyová
- Department of Zoology and Anthropology, Constantine the Philosopher University, Nitra, Slovakia
| | - Katarína Orendáčová
- Department of Zoology and Anthropology, Constantine the Philosopher University, Nitra, Slovakia
| | - Mária Vondráková
- Department of Zoology and Anthropology, Constantine the Philosopher University, Nitra, Slovakia
| | - Ida Petrovičová
- Department of Zoology and Anthropology, Constantine the Philosopher University, Nitra, Slovakia
| | - Miloš Mlynček
- Department of Nursing, Constantine the Philosopher University, Nitra, Slovakia
| | - Petr Weiss
- Department of Psychology, Charles University, Prague, Czech Republic
- Deaprtment of Psychology, Comenius University, Bratislava, Slovakia
| | - James G Pfaus
- Department of Psychology and Life Sciences, Faculty of Humanities, Charles University, Prague, Czech Republic
- Center for Sexual Health and Intervention, Czech National Institute of Mental Health, Klecany, Czech Republic
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Schmidt NM, Hennig J, Munk AJL. Interplay between sexual excitation and inhibition: impact on sexual function and neural correlates of erotic stimulus processing in women. Front Behav Neurosci 2024; 18:1386006. [PMID: 38813468 PMCID: PMC11133591 DOI: 10.3389/fnbeh.2024.1386006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/26/2024] [Indexed: 05/31/2024] Open
Abstract
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.
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Affiliation(s)
- Norina M. Schmidt
- Department of Differential and Biological Psychology, Justus-Liebig-University Giessen, Giessen, Germany
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Mangas P, Sierra JC, Álvarez-Muelas A, Cervilla O, Sánchez-Pérez GM, Granados R. Validation of the multidimensional model of the subjective orgasm experience in the context of same-sex relationships. Int J Clin Health Psychol 2024; 24:100474. [PMID: 38882232 PMCID: PMC11176964 DOI: 10.1016/j.ijchp.2024.100474] [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: 03/19/2024] [Accepted: 05/23/2024] [Indexed: 06/18/2024] Open
Abstract
Background/objective The Multidimensional Model of the Subjective Orgasm Experience (MMSOE) has been validated in the context of heterosexual relationships, with no evidence in the context of same-sex relationships. This study aims to examine the association of its dimensions (Affective, Intimacy, Sensory, and Rewards) with the propensity for sexual excitation, rating of sexual arousal, rating of genital sensations, and genital response. Method Sixty-eight young adults (34 males and 34 females) who were sexually active with people of the same sex participated in a laboratory task in which they viewed content-neutral and sexually explicit gay films. Regression models were conducted to explain the dimensions of MMSOE from measures of sexual arousal. Results In males, the rating of sexual arousal explained the Sensory dimension, while the genital response explained the Affective dimension, with sexual arousal as a state gaining more prominence. In females, however, the propensity for sexual excitation explained the Sensory dimension, with more salience of sexual arousal as a trait. Conclusions The MMSOE is shown to be a valid theoretical framework for the study of orgasmic experience in the context of same-sex relationships, with clear implications for clinical practice.
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Affiliation(s)
- Pablo Mangas
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain
| | - Juan Carlos Sierra
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain
| | - Ana Álvarez-Muelas
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain
| | - Oscar Cervilla
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain
| | | | - Reina Granados
- Department of Nursey, Health Sciences Faculty, University of Granada, Spain
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Touraille P, Ågmo A. Sex Differences in Sexual Motivation in Humans and Other Mammals: The Role of Conscious and Unconscious Processes. Behav Sci (Basel) 2024; 14:277. [PMID: 38667073 PMCID: PMC11047354 DOI: 10.3390/bs14040277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/20/2024] [Accepted: 03/24/2024] [Indexed: 04/29/2024] Open
Abstract
In self-report questionnaires, men report higher scores than women on variables such as desire for sex, frequency of sexual thoughts, number of sex partners, etc. Based on this, men are considered to have a higher level of sexual motivation than women. However, retrospective self-reports may be unsuitable for estimations of the inherent level of sexual motivation. We review data on automatic (unconsciously controlled) responses and measures of implicit motivation during exposure to sexual stimuli. These responses and measures are inaccessible to willful manipulations and make it possible to determine whether the sex difference in answers to questionnaires is replicated when volitional response manipulations are unlikely. We complement the human data with observations from some rodent and non-human primate species. The attentional resources allotted to stimuli with sexual relevance as well as genital responses to such stimuli are similar in men and women. Measures of implicit motivation also fail to detect any sex difference. Finally, the frequency of masturbation is superior in female infants before the age at which social expectations begin to determine behavior. Neither in rodents nor in non-human primates is there any clear-cut evidence for sex differences in motivation. It seems that males and females are similar with regard to the intensity of sexual motivation. The responses to questionnaires may be affected by social learning of sexual scripts and/or the inferior quality of sexual experiences in women, among other things.
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Affiliation(s)
- Priscille Touraille
- Centre National de la Recherche Scientifique (UMR 7206), Muséum National d’Histoire Naturelle, 75116 Paris, France;
| | - Anders Ågmo
- Department of Psychology, University of Tromsø, 9037 Tromsø, Norway
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12
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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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13
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Bittoni C, Kiesner J. When the brain turns on with sexual desire: fMRI findings, issues, and future directions. Sex Med Rev 2023; 11:296-311. [PMID: 37500582 DOI: 10.1093/sxmrev/qead029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 07/29/2023]
Abstract
INTRODUCTION More than 2 decades of neuroimaging research has sought to uncover the neurologic basis of sexual desire. However, the lack of a clear conceptual distinction between sexual desire and sexual arousal or even a broadly accepted definition of sexual desire has led to confusion in the literature regarding brain areas uniquely associated with sexual desire. OBJECTIVES (1) To critically review the neuroimaging literature that seeks to identify brain areas and networks involved in sexual desire; (2) to identify and discuss those brain areas and potential networks that are most promising for providing insights to sexual desire; and (3) to offer recommendations for future studies. METHODS Existing meta-analyses were used as a starting point to identify relevant neuroimaging studies on sexual desire, arousal, and love. This base was then expanded via Google Scholar and forward citation tracking of already identified studies. RESULTS Brain areas that are commonly associated with sexual desire and arousal include the amygdala, hypothalamus, dorsal and ventral striatum, anterior cingulate, insula, and prefrontal and orbitofrontal cortex. However, because the same basic paradigm has been used to study sexual desire and arousal, unambiguous conclusions regarding areas uniquely involved in sexual desire cannot be drawn. Moreover, the lack of connectivity analyses and a failure to acknowledge negative BOLD (blood-oxygen level dependent) significantly limit conclusions on the neural basis of sexual desire. CONCLUSION Five recommendations are made. First, stimulus types (ie, erotic vs sexually explicit) should be selected by the meaningful theoretical conceptualization of the constructs of interest. Second, participants should be provided with definitions of sexual desire, mental sexual arousal, and perceived genital sexual arousal, so they can choose which terms best describe their experience. Third, event-related designs should be used with caution when investigating sexual desire. Fourth, time series analyses should be used to identify both positive and negative BOLD. Fifth, connectivity analyses should be performed to identify brain networks.
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Affiliation(s)
- Celeste Bittoni
- Department of Psychology (DPSS), University of Padova, Padova 35131, Italy
| | - Jeff Kiesner
- Department of Psychology (DPSS), University of Padova, Padova 35131, Italy
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14
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Janssen E, Bancroft J. The Dual Control Model of Sexual Response: A Scoping Review, 2009-2022. JOURNAL OF SEX RESEARCH 2023; 60:948-968. [PMID: 37267113 DOI: 10.1080/00224499.2023.2219247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Dual Control Model proposes that sexual arousal and related processes are dependent on the balance between sexual excitation and sexual inhibition, and that individuals vary in their propensity for these processes. This scoping review provides an overview and discussion of the questionnaires used to measure the propensities for sexual excitation and inhibition, their translation and validation in other languages, and their application in empirical research on topics ranging from sexual desire and arousal, sexual (dys)function, sexual risk taking, asexuality, hypersexuality, and sexual aggression. A total of 152 papers, published between 2009 and 2022 and identified using online databases, were included in this review. The findings, consistent with those reviewed by Bancroft et al. (2009), suggest that sexual excitation is particularly relevant to sexual desire and responsivity and predictive of asexuality and hypersexuality. Sexual inhibition plays a role in sexual dysfunction. sexual risk taking, and sexual aggression, although often in interaction with sexual excitation. Suggestions for the further development of the model and for future studies are discussed.
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Affiliation(s)
- Erick Janssen
- Institute for Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Belgium
- The Kinsey Institute, Indiana University, Bloomington, IN, USA
| | - John Bancroft
- Horspath, Oxfordshire, UK
- The Kinsey Institute, Indiana University, Bloomington, IN, USA
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15
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Kiesner J, Bittoni C, Eisenlohr-Moul T, Komisaruk B, Pastore M. Menstrual cycle-driven vs noncyclical daily changes in sexual desire. J Sex Med 2023; 20:756-765. [PMID: 37037659 DOI: 10.1093/jsxmed/qdad032] [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: 09/17/2022] [Revised: 02/14/2023] [Accepted: 02/21/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Past research on the association between sexual desire and the menstrual cycle has provided inconclusive results and has not considered the potential influence of psychological and physical changes that are frequently associated with the menstrual cycle. AIM To test the strength of association between the menstrual cycle (and associated symptoms) and changes in sexual desire. METHODS Prospective daily reports across 2 full menstrual cycles (2 months) from a sample of female university students (n = 213), were analysed. Analyses tested for average effects of the menstrual cycle on sexual desire, individual differences in these effects, and cyclical and noncyclical associations between sexual desire and the 9 menstrual cycle-related changes. Note that data presented in the current article come from a larger study from which other reports have been published. OUTCOMES Target variables were (1) daily change in sexual desire and (2) daily reports of 5 psychological changes and 4 physical changes that are commonly associated with the menstrual cycle. RESULTS Results showed that when considering average effects across participants, the menstrual cycle was associated with a small midcycle increase in sexual desire. However, multilevel analyses showed large individual differences in how the menstrual cycle influences sexual desire. Specifically, some participants showed a midcycle increase, others a perimenstrual increase, and others no change across the menstrual cycle. Moreover, results demonstrated that psychological changes were more important for predicting sexual desire as compared with physical changes. CLINICAL IMPLICATIONS These results suggest that daily measurement of sexual desire across multiple menstrual cycles may be an important tool in the assessment of sexual desire among some females. STRENGTHS AND LIMITATIONS Strengths of this study are the daily assessment of sexual desire and all symptoms for 2 menstrual cycles and multilevel analyses that allow the study of individual differences. Limitations include limited measurement of sexual desire based on only 2 questions and the lack of measures of relationship status and sexual orientation. CONCLUSION Emphasis is placed on the need to apply more rigorous research methods and to abandon simplistic average-effects models that are based on outdated theories and stereotypes.
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Affiliation(s)
- Jeff Kiesner
- Department of Psychology, Università Degli Studi di Padova, Padova 35131, Italy
| | - Celeste Bittoni
- Department of Psychology, Università Degli Studi di Padova, Padova 35131, Italy
| | - Tory Eisenlohr-Moul
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Barry Komisaruk
- Psychology Department, Rutgers University, Newark, NJ 07102, United States
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Cervilla O, Jiménez-Antón E, Álvarez-Muelas A, Mangas P, Granados R, Sierra JC. Solitary Sexual Desire: Its Relation to Subjective Orgasm Experience and Sexual Arousal in the Masturbation Context within a Spanish Population. Healthcare (Basel) 2023; 11:healthcare11060805. [PMID: 36981462 PMCID: PMC10048235 DOI: 10.3390/healthcare11060805] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 03/30/2023] Open
Abstract
The tridimensional sexual desire proposal (i.e., dyadic to partner, dyadic to attractive other and solitary) has been empirically supported. However, solitary sexual desire and its relationship to other dimensions of sexual functioning has received less attention. Hence, we examined the capacity of solitary sexual desire to explain the subjective orgasm experience (Study 1) and sexual arousal (Study 2) in the context of solitary masturbation. Study 1, composed of 2406 heterosexual adults (M age = 39.72, SD = 11.81), assessed for solitary sexual desire, dyadic sexual desire, and the intensity of the subjective orgasm experience obtained through solitary masturbation, along with other associated parameters. Study 2, consisting of 41 heterosexual young people (M age = 22.49, SD = 3.17), evaluated the genital response (penile circumference/vaginal pulse amplitude) and subjective arousal to sexually explicit films related to solitary masturbation. In both men and women, solitary sexual desire accounted for a significant percentage of the subjective orgasm experience obtained through solitary masturbation. In addition, in women, the propensity for sexual arousal was explained by solitary sexual desire. It is concluded that solitary sexual desire -as opposed to dyadic- is important to explain sexual arousal and orgasm in the solitary masturbation context. These results highlight the importance of addressing sexual desire in the solitary context, given its implications with other dimensions of sexual functioning.
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Affiliation(s)
- Oscar Cervilla
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain
| | - Eva Jiménez-Antón
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain
| | - Ana Álvarez-Muelas
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain
| | - Pablo Mangas
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain
| | - Reina Granados
- Department of Nursey, Health Sciences Faculty, University of Granada, 18071 Granada, Spain
| | - Juan Carlos Sierra
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain
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17
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Aguiar S, Carvalho J, Carrito ML, Santos IM. Automatic attention to sexual stimuli: exploring the role of neuroticism and sexual excitation/inhibition through event-related potentials. J Sex Med 2023; 20:367-376. [PMID: 36763959 DOI: 10.1093/jsxmed/qdac048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Previous findings have shown that neuroticism is a higher-order vulnerability factor in the development and maintenance of sexual dysfunctions and can have an impact on the attentional processing of sexual stimuli; however, the influence of psychosexual dimensions on the early automatic phases of such cognitive processes has not been established yet. AIM To examine the mediating role of sexual inhibition/excitation propensity in the relationship between neuroticism and automatic attention to visual erotica and to identify the neuroelectric correlates of such a process. METHODS We analyzed the answers provided by 58 individuals on the Neuroticism subscale of the NEO Personality Inventory-Revised and the Sexual Inhibition/Excitation Scales. Event-related potentials (ERPs) were recorded during a modified oddball paradigm containing romantic and sexually explicit pictures. Parallel mediations were performed to simultaneously test the mediating role of sexual inhibition/excitation in the relationship between neuroticism and each ERP. OUTCOMES Three early attention ERP components (P1, P2, and N2) were assessed. RESULTS Findings revealed an indirect effect of neuroticism on automatic attention, via sexual inhibition due to threat of performance failure (SIS1), for romantic and sexually explicit stimuli. This effect was significant only for component N2, which showed increased amplitudes and earlier latencies in participants with high SIS1. CLINICAL IMPLICATIONS Sexual stimuli, due to their emotional valence and arousal potential, might be perceived as virtually threatening by individuals with neuroticism, who may benefit from strategies that decrease hyperarousal and sympathetic activation. STRENGTHS AND LIMITATIONS This was one of the first studies to analyze neuroelectric activity associated with automatic attention toward sexual stimuli in relation to personality and sexual excitation/inhibition propensity. Nevertheless, the limited number of participants demands caution in generalizing the results. CONCLUSION These results provide a better understanding of the relationship between personality and sexual cognition and open new avenues of research in relation to other automatic cognitive phenomena related to human sexual behavior.
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Affiliation(s)
- Sandra Aguiar
- Center for Psychology at the University of Porto, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Joana Carvalho
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Mariana L Carrito
- Center for Psychology at the University of Porto, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Isabel M Santos
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
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18
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Skorska MN, Yule MA, Bogaert AF, Brotto LA. Patterns of Genital and Subjective Sexual Arousal in Cisgender Asexual Men. JOURNAL OF SEX RESEARCH 2023; 60:253-270. [PMID: 35609125 DOI: 10.1080/00224499.2022.2071411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Human asexuality has been defined as a lack of sexual attraction to others, although its nature is not well understood. Asexual men's genital and subjective sexual arousal patterns were compared to sexual men's to better understand asexual men's sexual response patterns. Using a penile plethysmograph to measure genital arousal, 20 asexual, 27 heterosexual, and 22 gay cisgender men (M age = 28.28, SD = 9.41) viewed erotic films depicting sexual activity or masturbation, and a subsample engaged in sexual fantasy of their choosing. Questionnaires assessing sexual function and behavior were also completed. Asexual men scored lower on sexual desire and orgasmic function, higher on sexual aversion, and did not differ on overall sexual satisfaction. Compared with gay and heterosexual men, asexual men demonstrated lower genital and subjective sexual arousal to the erotic films but displayed similar sexual arousal when engaging in sexual fantasy. Asexual men's lower levels of sexual excitation rather than their higher levels of sexual inhibition were associated with lower responses to the erotic films. These findings suggest asexual men have preferred sexual stimuli that differ from sexual men and have a similar capacity for sexual arousal as sexual men. Collectively these findings add to a growing literature aiming to understand the nature of asexuality.
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Affiliation(s)
- Malvina N Skorska
- Child & Youth Psychiatry, Centre for Addiction and Mental Health, Brock University
| | | | | | - Lori A Brotto
- Department of Obstetrics & Gynaecology, University of British Columbia
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19
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Wen G, Niu C, Zhang Y, Santtila P. Bidirectional relationship between sexual arousal and (sex-related) disgust. PLoS One 2023; 18:e0285596. [PMID: 37167289 PMCID: PMC10174547 DOI: 10.1371/journal.pone.0285596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/26/2023] [Indexed: 05/13/2023] Open
Abstract
Sexual stimuli provoke both sexual arousal and disgust, and the coaction between these emotions determines sexually behavioral outcomes. The current research includes two experiments to explore the bidirectional relationship between sexual arousal toward erotic stimuli and disgust induced by sexual body fluids. Study 1 presented 234 participants (117 women) with sexual body (vs. neutral) fluids followed by erotic stimuli, and Study 2 presented 235 participants (117 women) with erotic (vs. neutral) videos followed by sexual body fluids (and a non-sex-related stimulus). Study 1 showed that exposure to sexual body fluids reduced sexual arousal and the likelihood of sexual engagement toward erotic stimuli in participants with high sexual disgust sensitivity but increased sexual arousal and the likelihood of sexual engagement in participants with low sexual disgust sensitivity, while Study 2 suggested that men exposed to erotic (vs. neutral) stimuli reported lower disgust, stronger sexual arousal state, and higher willingness to interact with the sexual body fluids. There was no relationship between subjective feelings of sexual arousal and disgust in these experiments, while the balance of sexual arousal and disgust toward sexual body fluids and erotic stimuli had a positive association. Also, exposure to erotic stimuli had no effect on reactions to generally disgusting stimulus, but feelings of sexual arousal toward erotic stimuli were positively associated with disgust induced by generally disgusting fluid. These findings suggest that Behavior Immune System regulates disgust to establish a balance between benefit and cost related to sex as well as provide insight into the process underlying sexual dysfunctions.
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Affiliation(s)
- Guangju Wen
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
- Faculty of Arts and Sciences, NYU Shanghai, Shanghai, People's Republic of China
| | - Caoyuan Niu
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
- Faculty of Arts and Sciences, NYU Shanghai, Shanghai, People's Republic of China
| | - Yikang Zhang
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Pekka Santtila
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
- Faculty of Arts and Sciences, NYU Shanghai, Shanghai, People's Republic of China
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20
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Mata-Marín D, Pineda-Pardo JÁ, Michiels M, Pagge C, Ammann C, Martínez-Fernández R, Molina JA, Vela-Desojo L, Alonso-Frech F, Obeso I. A circuit-based approach to modulate hypersexuality in Parkinson's disease. Psychiatry Clin Neurosci 2022; 77:223-232. [PMID: 36579893 DOI: 10.1111/pcn.13523] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 12/30/2022]
Abstract
AIM Impulse-control disorder is a common neuropsychiatric complication in Parkinson's disease (PD) under dopamine replacement therapy. Prior studies tested the balance between enhanced desire towards reward and cognitive control deficits, hypothesized to be biased towards the former in impulse control disorders. We provide evidence for this hypothesis by measuring behavioral and neural patterns behind the influence of sexual desire over response inhibition and tools towards functional restoration using repetitive transcranial stimulation in patients with hypersexuality as predominant impulsive disorder. METHODS The effect of sexual cues on inhibition was measured with a novel erotic stop-signal task under on and off dopaminergic medication. Task-related functional and anatomical connectivity models were estimated in 16 hypersexual and 17 nonhypersexual patients with PD as well as in 17 healthy controls. Additionally, excitatory neuromodulation using intermittent theta-burst stimulation (sham-controlled) was applied over the pre-supplementary motor area in 20 additional hypersexual patients with PD aiming to improve response inhibition. RESULTS Compared with their nonhypersexual peers, patients with hypersexuality recruited caudate, pre-supplementary motor area, ventral tegmental area, and anterior cingulate cortex while on medication. Reduced connectivity was found between pre-supplementary motor area and caudate nucleus in hypersexual compared with nonhypersexual patients (while medicated), a result paralleled by compensatory enhanced anatomical connectivity. Furthermore, stimulation over the pre-supplementary motor area improved response inhibition in hypersexual patients with PD when exposed to sexual cues. CONCLUSION This study, therefore, has identified a specific fronto-striatal and mesolimbic circuitry underlying uncontrolled sexual responses in medicated patients with PD where cortical neuromodulation halts its expression.
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Affiliation(s)
- David Mata-Marín
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.,PhD program in Neuroscience, Autonoma University of Madrid, Madrid, Spain
| | - José Ángel Pineda-Pardo
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | - Mario Michiels
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.,PhD program in Neuroscience, Autonoma University of Madrid, Madrid, Spain
| | - Cristina Pagge
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,PhD program in Neuroscience, Autonoma University of Madrid, Madrid, Spain
| | - Claudia Ammann
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain
| | - Raúl Martínez-Fernández
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | | | | | | | - Ignacio Obeso
- Centro Integral de Neurociencias Abarca Campal (HM CINAC), Hospital Universitario HM Puerta del Sur. HM Hospitales, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.,Department of Psychobiology & Methods for the Behavioral Sciences Department, Complutense University of Madrid, Madrid, Spain
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21
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Jones HR, Lorenz TK. Higher sexual excitation is associated with an increase in sex-linked substance use in women with a history of unwanted sexual contact. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2022; 31:432-442. [PMID: 37274840 PMCID: PMC10237101 DOI: 10.3138/cjhs.2022-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Survivors of unwanted sexual contact have an increased likelihood of using substances in sexual situations, which puts them at heightened risk for intoxication-related harms. Separately, research has indicated that women may intentionally use substances in sexual situations to either enhance pleasure (i.e., increase sexual excitation) and/or reduce sexual anxiety or shame (i.e., reduce sexual inhibition), a phenomenon termed sex-linked substance use (SLSU). A predominant assumption in the literature is that women with unwanted sex histories are more likely to disengage during sex, suggesting greater inhibition-related SLSU; however, there is little prior research directly examining if women who have unwanted sex histories primarily engage in SLSU to increase sexual excitation or decrease inhibitions. We conducted exploratory analyses of an online survey in a convenience sample of 516 undergraduate women including data on their history of unwanted sex, SLSU, and sexual excitation/inhibition. Sexual excitation mediated the association between a history of unwanted sexual contact and SLSU, suggesting that women with unwanted sexual histories reported higher levels of sexual excitation, which in turn was associated with a higher likelihood of using substances to increase pleasure during sexual activity. Specifically, arousability, partner characteristics, and power dynamics subfactors were significant mediators. Sexual inhibition did not mediate the relationship between a history of unwanted sexual contact and SLSU, suggesting that women with unwanted sex histories may have been less likely to use substances to reduce sexual inhibitions. If replicated, these findings suggest that sexual excitation may be a useful target of intervention surrounding SLSU, particularly in women with histories of unwanted sexual contact. Specifically, treatments targeting cognitive and affective tendencies associated with sexual excitation may help women who engage in SLSU to have safe, pleasurable sexual activity, without increasing the risk of intoxication-related harms.
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Affiliation(s)
- Harper R. Jones
- Department of Psychology, University of Nebraska–Lincoln, Lincoln, Nebraska, United States
- Center for Brain Biology and Behavior, University of Nebraska–Lincoln, Lincoln, Nebraska, United States
| | - Tierney K. Lorenz
- Department of Psychology, University of Nebraska–Lincoln, Lincoln, Nebraska, United States
- Center for Brain Biology and Behavior, University of Nebraska–Lincoln, Lincoln, Nebraska, United States
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22
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Turner D, Briken P, Grubbs J, Malandain L, Mestre-Bach G, Potenza MN, Thibaut F. The World Federation of Societies of Biological Psychiatry guidelines on the assessment and pharmacological treatment of compulsive sexual behaviour disorder. DIALOGUES IN CLINICAL NEUROSCIENCE 2022; 24:10-69. [PMID: 37522807 PMCID: PMC10408697 DOI: 10.1080/19585969.2022.2134739] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/18/2022] [Accepted: 10/03/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The current guidelines aim to evaluate the role of pharmacological agents in the treatment of patients with compulsive sexual behaviour disorder (CSBD). They are intended for use in clinical practice by clinicians who treat patients with CSBD. METHODS An extensive literature search was conducted using the English-language-literature indexed on PubMed and Google Scholar without time limit, supplemented by other sources, including published reviews. RESULTS Each treatment recommendation was evaluated with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. Psychoeducation and psychotherapy are first-choice treatments and should always be conducted. The type of medication recommended depended mainly on the intensity of CSBD and comorbid sexual and psychiatric disorders. There are few randomised controlled trials. Although no medications carry formal indications for CSBD, selective-serotonin-reuptake-inhibitors and naltrexone currently constitute the most relevant pharmacological treatments for the treatment of CSBD. In cases of CSBD with comorbid paraphilic disorders, hormonal agents may be indicated, and one should refer to previously published guidelines on the treatment of adults with paraphilic disorders. Specific recommendations are also proposed in case of chemsex behaviour associated with CSBD. CONCLUSIONS An algorithm is proposed with different levels of treatment for different categories of patients with CSBD.
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Affiliation(s)
- Daniel Turner
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joshua Grubbs
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Leo Malandain
- Department of Psychiatry and Addictive Disorders, University Hospital Cochin (site Tarnier) AP-HP, Paris, France
| | - Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, La Rioja, Spain
| | - Marc N. Potenza
- Departments of Psychiatry and Neuroscience and Child Study Center, Yale School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Florence Thibaut
- Department of Psychiatry and Addictive Disorders, University Hospital Cochin (site Tarnier) AP-HP, Paris, France
- INSERM U1266, Institute of Psychiatry and Neurosciences, University of Paris Cité, Paris, France
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Balzarini RN, Muise A, Zoppolat G, Gesselman AN, Lehmiller JJ, Garcia JR, Slatcher RB, Mark KP. Sexual Desire in the Time of COVID-19: How COVID-Related Stressors Are Associated with Sexual Desire in Romantic Relationships. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3823-3838. [PMID: 36100726 PMCID: PMC9469826 DOI: 10.1007/s10508-022-02365-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic and the resulting social distancing measures have caused widespread social and economic disruptions, resulting in spikes in unemployment and financial instability, along with drastic changes to people's ability to feel socially connected. Many of the changes resulting from the COVID-19 pandemic are risk factors for depressive symptoms, which are associated with lower levels of sexual desire. The current research (N = 4,993) examined whether responses to external stressors brought on by COVID-19 (i.e., financial concern, worry, loneliness, stress) were associated with sexual desire among a multi-national sample of people in relationships (Studies 1-2), and whether this association was, in part, due to reports of depressive symptoms (Study 2). In the period immediately following the onset of the pandemic, more financial concern (Study 1) and worry (Study 2) were associated with higher sexual desire, while other factors, like stress (Studies 1-2), were associated with lower desire. We also followed a subset of participants every two weeks during the initial stages of the pandemic and at times when people reported greater stress, loneliness, financial strain, or worry than their average, they reported greater depressive symptoms, which was, in turn, associated with lower sexual desire. Results suggest that the social isolation and stress resulting from the COVID-19 pandemic have mixed associations with sexual desire at the onset of the pandemic. But over time, when people report heightened COVID-related stressors, they tend to report lower sexual desire for their partner, in part because these stressors are associated with more depressive symptoms.
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Affiliation(s)
- Rhonda N Balzarini
- Department of Psychology, Texas State University, San Marcos, TX, 78666, USA.
- The Kinsey Institute, Indiana University, Bloomington, IN, USA.
| | - Amy Muise
- Department of Psychology, York University, Toronto, ON, Canada
| | - Giulia Zoppolat
- Department of Experimental and Applied Psychology, Vrije University, Amsterdam, Netherlands
| | | | | | - Justin R Garcia
- The Kinsey Institute, Indiana University, Bloomington, IN, USA
- Department of Gender Studies, Indiana University, Bloomington, IN, USA
| | | | - Kristen P Mark
- The Kinsey Institute, Indiana University, Bloomington, IN, USA
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
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24
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Bittoni C, Kiesner J. Sexual Desire in Women: Paradoxical and Nonlinear Associations with Anxiety and Depressed Mood. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3807-3822. [PMID: 36123564 PMCID: PMC9663363 DOI: 10.1007/s10508-022-02400-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 08/03/2022] [Accepted: 08/12/2022] [Indexed: 06/01/2023]
Abstract
The aim of the present study was to expand previous findings regarding paradoxical effects of negative mood on sexual desire. This was done by considering the full range of depressed mood and anxiety symptoms and using methods that are unaffected by recall bias and that don't require participants to infer causal associations between their mood and sexual desire. A convenience sample of 213 university students completed daily questionnaires for approximately two months. Multilevel random-effects models were used to estimate average effects for the entire sample and to test for variability across participants in the associations between negative mood and sexual desire, controlling also for potential influences of the menstrual cycle. Previous findings showing that some women report decreased sexual desire and others increased sexual desire when depressed or anxious were confirmed. More importantly, for both depressed mood and anxiety, results demonstrated the presence of within-person paradoxical associations, whereby there were some women for whom both low and high levels of negative mood were associated with the same change (an increase or a decrease) in sexual desire. Related to these diverse response patterns, paradoxical associations between negative mood and sexual desire were also present at low levels of negative mood. The discussion underlines the importance of considering individual variability and multifactorial nonlinear models when studying sexual desire.
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Affiliation(s)
- Celeste Bittoni
- Department of Development and Social Psychology, University of Padova, via Venezia 8, 35131, Padua, Italy
| | - Jeff Kiesner
- Department of Development and Social Psychology, University of Padova, via Venezia 8, 35131, Padua, Italy.
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25
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van Tuijl P, Verboon P, van Lankveld J. The Relation of Mood and Sexual Desire: An Experience Sampling Perspective on the Dual Control Model. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3871-3886. [PMID: 35896937 PMCID: PMC9663403 DOI: 10.1007/s10508-022-02357-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 06/15/2023]
Abstract
We investigated the effect of fluctuations in negative and positive affect on momentary sexual motivation in a sample of women and men in a steady relationship (n = 133). Sexual motivation was regarded as the aggregate of sexual desire, subjective sexual arousal and openness to sexual contact. Experience sampling methodology was used to collect up to 70 measurements per participant over a period of seven consecutive days of sexual motivation, and negative and positive affect. Using multilevel analysis, we investigated cross-level interactions between affect and trait measures as specified in the dual control model (DCM). This model postulates sexually excitatory and inhibitory mechanisms as relatively independent systems that together can explain individual differences in sexual motivation and behavior. Results implicated that any intensification of feelings, positive or negative, was associated with a momentary increase in sexual motivation for participants more prone to sexual excitation. In the lagged analysis, higher preceding negative affect, measured 1-2 h earlier, forecasted an increase in current sexual motivation for participants more prone to sexual excitation. The lagged analysis included the autoregressive effect or inertia of sexual motivation. Inertia reflects the extent to which sexual motivation lingers and persists at similar levels. Our findings showed that sexual motivation levels persisted less in individuals with higher sexual inhibition proneness due to threat of performance failure. This study demonstrated how experience sampling methodology can be used to extend research on associations between mood and sexual motivation and implicates that DCM factors moderate these associations.
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Affiliation(s)
- Piet van Tuijl
- Department of Psychology, Open Universiteit, 6419, Heerlen, The Netherlands.
- , Egelantierstraat 138, 3551GG, Utrecht, Netherlands.
| | - Peter Verboon
- Department of Psychology, Open Universiteit, 6419, Heerlen, The Netherlands
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26
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Berner W. Sexualität zwischen Lustprinzip und Wiederholungszwang. PDP - PSYCHODYNAMISCHE PSYCHOTHERAPIE 2022. [DOI: 10.21706/pdp-21-4-341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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27
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Wells TJ, Krejčová L, Binter J, Pfaus JG, Horsley RR. No significant effect of frequent online sexual behaviour on Pavlovian-to-instrumental transfer (PIT): Implications for compulsive sexual behaviour disorder. PLoS One 2022; 17:e0274913. [PMID: 36178949 PMCID: PMC9524690 DOI: 10.1371/journal.pone.0274913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 09/06/2022] [Indexed: 11/19/2022] Open
Abstract
Reward based learning is broadly acknowledged to underpin the development and maintenance of addictive behaviour although the mechanism in sexual compulsivity is less understood. Using a Pavlovian-to-Instrumental Transfer (PIT) task we tested whether the motivational aspect of conditioned Pavlovian conditioned stimulus invigorated instrumental responding in relation to specific compatible monetary rewards. Performance on the task was analysed between two groups of males based on Low (N = 38) and High (N = 41) self-report online sexual behaviour (OSB). Psychometric tests including sexual compulsivity scale and behavioural activation/behavioural inhibition (BIS/BAS) were also administered to determine the relationship between OSB and general reward sensitivity. We show clear evidence of acquisition in the Pavlovian and instrumental conditioning phases. Specific transfer effect was greater in the High-OSB group although the difference compared to the Low-OSB group was non-significant. OSB negatively correlated with both BIS and BAS indicative of introversion and low reward sensitivity. OSB positively correlated with sexual compulsivity although it is unclear whether individuals in the High-OSB group considered their behaviour either excessive or problematic. These findings contribute to the ongoing debate regarding the nature of problematic OSB. Fundamental differences in motivational characteristics and mechanism contributing to compulsive behaviour in relation to high-OSB might indicate incompatibility with behavioural addiction models. PIT was not enhanced in high-OSB by appetitive conditioning, although problematic OSB could stem from failure to inhibit actions. Further research should investigate whether aversive conditioning differentially affects responding in high-OSB individuals, potentially explaining perseverant behaviour despite negative consequences.
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Affiliation(s)
- Timothy J. Wells
- Center for Sexual Health and Intervention, Czech National Institute of Mental Health, Klecany, Czech Republic
- * E-mail:
| | - Lucie Krejčová
- Center for Sexual Health and Intervention, Czech National Institute of Mental Health, Klecany, Czech Republic
| | - Jakub Binter
- Department of Philosophy and History of Science, Charles University, Prague, Czech Republic
| | - James G. Pfaus
- Center for Sexual Health and Intervention, Czech National Institute of Mental Health, Klecany, Czech Republic
- Department of Psychology and Life Sciences, Charles University, Prague, Czech Republic
| | - Rachel R. Horsley
- Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
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The Risks and Benefits of Being “Early to Bed": Toward a Broader Understanding of Age at Sexual Debut and Sexual Health in Adulthood. J Sex Med 2022; 19:1343-1358. [DOI: 10.1016/j.jsxm.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/18/2022]
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29
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Pfaus JG. Politics of Sexual Desire. CURRENT SEXUAL HEALTH REPORTS 2022. [DOI: 10.1007/s11930-022-00335-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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30
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Quintana GR, Mac Cionnaith CE, Pfaus JG. Behavioral, Neural, and Molecular Mechanisms of Conditioned Mate Preference: The Role of Opioids and First Experiences of Sexual Reward. Int J Mol Sci 2022; 23:8928. [PMID: 36012194 PMCID: PMC9409009 DOI: 10.3390/ijms23168928] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 12/20/2022] Open
Abstract
Although mechanisms of mate preference are thought to be relatively hard-wired, experience with appetitive and consummatory sexual reward has been shown to condition preferences for partner related cues and even objects that predict sexual reward. Here, we reviewed evidence from laboratory species and humans on sexually conditioned place, partner, and ejaculatory preferences in males and females, as well as the neurochemical, molecular, and epigenetic mechanisms putatively responsible. From a comprehensive review of the available data, we concluded that opioid transmission at μ opioid receptors forms the basis of sexual pleasure and reward, which then sensitizes dopamine, oxytocin, and vasopressin systems responsible for attention, arousal, and bonding, leading to cortical activation that creates awareness of attraction and desire. First experiences with sexual reward states follow a pattern of sexual imprinting, during which partner- and/or object-related cues become crystallized by conditioning into idiosyncratic "types" that are found sexually attractive and arousing. These mechanisms tie reward and reproduction together, blending proximate and ultimate causality in the maintenance of variability within a species.
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Affiliation(s)
- Gonzalo R. Quintana
- Departamento de Psicología y Filosofía, Facultad de Ciencias Sociales y Jurídicas, Universidad de Tarapacá, Arica 1000007, Chile
| | - Conall E. Mac Cionnaith
- Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montreal, QC H4B1R6, Canada
| | - James G. Pfaus
- Department of Psychology and Life Sciences, Faculty of Humanities, Charles University, 182 00 Prague, Czech Republic
- Division of Sexual Neuroscience, Center for Sexual Health and Intervention, Czech National Institute of Mental Health, 250 67 Klecany, Czech Republic
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31
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The neurobiology of bremelanotide for the treatment of hypoactive sexual desire disorder in premenopausal women. CNS Spectr 2022; 27:281-289. [PMID: 33455598 DOI: 10.1017/s109285292100002x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Hypoactive sexual desire disorder (HSDD) is a common female sexual dysfunction and is estimated to affect approximately 10% of women in the United States. It has been suggested that HSDD is associated with an imbalance of hormone and neurotransmitter levels in the brain, resulting in decreased excitation, increased inhibition, or a combination of both. Evidence suggests neurotransmitters, including dopamine (DA), norepinephrine, and serotonin, as well as hormones such as estradiol and testosterone, contribute to female sexual desire and response. Current treatments for HSDD include psychotherapy, and two US Food and Drug Administration-approved medications for premenopausal women: flibanserin, a serotonin mixed agonist and antagonist, and bremelanotide, a melanocortin receptor (MCR) agonist. Melanocortins are endogenous neuropeptides associated with the excitatory pathway of the female sexual response system. MCRs are found throughout the body, including the brain. Bremelanotide is an MCR agonist that nonselectively activates several of the receptor subtypes, of which subtype 4 (MC4R) is the most relevant at therapeutic doses. MC4R is predominantly expressed in the medial preoptic area (mPOA) of the hypothalamus in the brain, and is important for female sexual function. Animal studies suggest that bremelanotide may affect female sexual desire by activating presynaptic MC4Rs on neurons in the mPOA of the hypothalamus, leading to increased release of DA, an excitatory neurotransmitter that increases sexual desire. This review presents what is known about the mechanism of action of bremelanotide in the context of treating HSDD.
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32
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Ågmo A, Laan E. Sexual incentive motivation, sexual behavior, and general arousal: Do rats and humans tell the same story? Neurosci Biobehav Rev 2022; 135:104595. [PMID: 35231490 DOI: 10.1016/j.neubiorev.2022.104595] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/28/2022] [Accepted: 02/24/2022] [Indexed: 12/13/2022]
Abstract
Sexual incentive stimuli activate sexual motivation and heighten the level of general arousal. The sexual motive may induce the individual to approach the incentive, and eventually to initiate sexual acts. Both approach and the ensuing copulatory interaction further enhance general arousal. We present data from rodents and humans in support of these assertions. We then suggest that orgasm is experienced when the combined level of excitation surpasses a threshold. In order to analyze the neurobiological bases of sexual motivation, we employ the concept of a central motive state. We then discuss the mechanisms involved in the long- and short-term control of that state as well as those mediating the momentaneous actions of sexual incentive stimuli. This leads to an analysis of the neurobiology behind the interindividual differences in responsivity of the sexual central motive state. Knowledge is still fragmentary, and many contradictory observations have been made. Nevertheless, we conclude that the basic mechanisms of sexual motivation and the role of general arousal are similar in rodents and humans.
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Affiliation(s)
- Anders Ågmo
- Department of Psychology, University of Tromsø, Norway.
| | - Ellen Laan
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam UMC, University of Amsterdam, The Netherlands
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Sundgren M, Damiris I, Stallman H, Kannis-Dymand L, Millear P, Mason J, Wood A, Allen A. Investigating psychometric measures of sexual wellbeing: a systematic review. SEXUAL AND RELATIONSHIP THERAPY 2022. [DOI: 10.1080/14681994.2022.2033967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Madison Sundgren
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Isabella Damiris
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Helen Stallman
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Lee Kannis-Dymand
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Prudence Millear
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Jonathan Mason
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Australia
- Sunshine Coast Mind & Neuroscience – Thompson Institute, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Andrew Wood
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Australia
- Sunshine Coast Mind & Neuroscience – Thompson Institute, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Andrew Allen
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Australia
- Sunshine Coast Mind & Neuroscience – Thompson Institute, University of the Sunshine Coast, Sunshine Coast, Australia
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34
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Obesity, Body Image Dissatisfaction, and Sexual Dysfunction: A Narrative Review. SEXES 2022. [DOI: 10.3390/sexes3010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
With approximately two-thirds of the United States adult population classified as overweight or obese, obesity remains a critical public health concern. Obesity not only contributes to several health complications including type 2 diabetes mellitus and cardiovascular disease, but the condition is also associated with sexual dysfunction in both women and men. Despite evidence linking obesity and its concomitant pathophysiology to sexual problems, the potential roles of psychosocial factors such as body image are understudied. This narrative review evaluates the research linkages between obesity and sexual dysfunction, with particular attention to the potential effects of body image dissatisfaction. A literature search of biomedical and psychological databases was used to identify research pertaining to obesity, sexual function, and/or body image constructs. The pathophysiological effects of obesity on sexual function are well-documented in mechanistic studies and animal trials, often with corroboration in human clinical samples. However, very few studies examine obesity, body image, and sexual function in tandem. Body image dissatisfaction appears to independently impinge upon the sexual response cycle and mental health outcomes, irrespective of body weight. While obesity is often associated with negative body image appraisal, it is unclear whether these constructs exert additive, synergistic, or antagonistic effects on sexual responsivity. Additionally, overweight/obese individuals who exhibit higher levels of body image satisfaction or self-confidence appear to be protected from the deleterious effects of obesity on sexual satisfaction, at least to some extent. Greater reliance upon conceptual/theoretical models from the body image literature may better clarify the relationships between these constructs.
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35
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Gomes ALQ, Janssen E, Ganesean A, Nobre PJ. Sexual Inhibition and Sexual Excitation Profiles in Men With and Without Erectile Disorder. Urology 2021; 161:71-75. [PMID: 34929238 DOI: 10.1016/j.urology.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 11/07/2021] [Accepted: 12/05/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To investigate sexual excitation (SE) and sexual inhibition (SI) profiles in men with erectile dysfunction (ED) and to examine how these dimensions discriminate between men with and without ED. METHODS A clinical sample of 37 men with situational (psychogenic) ED and a control group of 40 sexually healthy men (matching the clinical group in age, marital status, and educational level) were constituted. Participants completed self-reported questionnaires assessing sexual function and the propensity for SI and SE. RESULTS Higher propensities for SI due to the threat of performance failure (SIS1, p < .001) and SI due to the threat of performance consequences (SIS2, p < .01) were found in the group of men with ED. No significant differences were found between the two groups in the propensity for SE. CONCLUSIONS Findings offer additional support for the Dual Control Model of Sexual Response and underscore the relevance of inhibitory mechanisms as potential psychobiological risk factors for the development and maintenance of ED. Findings also highlight the importance of a multidisciplinary approach in the clinical management of ED.
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Affiliation(s)
| | - Erick Janssen
- Institute for Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium and the Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, USA
| | - Adaikan Ganesean
- Section of Sexual Medicine, Obstetrics and Gynaecology, National University Hospital, National University of Singapore, Singapore
| | - Pedro J Nobre
- Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
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36
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Rodríguez-Nieto G, Dewitte M, Sack AT, Schuhmann T. Individual Differences in Testosterone and Self-Control Predict Compulsive Sexual Behavior Proneness in Young Males. Front Psychol 2021; 12:723449. [PMID: 34925132 PMCID: PMC8677662 DOI: 10.3389/fpsyg.2021.723449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
The ability to control sexual urges and impulses is essential to achieve individual and social harmony. Failing to regulate sexual behavior can lead to the interference with daily life goals, sexual diseases transmission and moral violations, among others. The dual control model of sexual response proposes that an imbalance between sexual excitation and sexual inhibition mechanisms may lead to sexual dysregulation, thereby explaining problematic sexual behavior. Interindividual differences in self-control and testosterone levels are likely to modulate sexual regulation mechanisms, but these individual features have scarcely been studied in the context of compulsive sexual behavior. This study investigated the role of sexual excitation and inhibition, self-control and testosterone levels in predicting individuals' proneness to display compulsive sexual behavior. Seventy healthy young males provided a saliva sample for testosterone measurements and filled in questionnaires on self-control, sexual excitation, sexual inhibition, sexual compulsivity and sexual behavior. High testosterone levels and low self-control were associated with higher sexual compulsivity scores. Additionally, testosterone levels and sexual inhibition negatively predicted the frequency of sexual behavior with a partner. The results of our study highlight the joint role of psychological traits and testosterone levels in compulsive sexual behavior proneness, providing implications regarding the prevention and treatment of this condition in young males.
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Affiliation(s)
- Geraldine Rodríguez-Nieto
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
- Movement Control and Neuroplasticity Research Group, Group Biomedical Sciences, Department of Movement Sciences, KU Leuven, Heverlee, Belgium
| | - Marieke Dewitte
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Alexander T. Sack
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Teresa Schuhmann
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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37
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Suijker CA, van Mazijk C, Keijzer FA, Meijer B. Phenomenological and existential contributions to the study of erectile dysfunction. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2021; 24:597-608. [PMID: 34106416 PMCID: PMC8557142 DOI: 10.1007/s11019-021-10029-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/03/2021] [Indexed: 06/12/2023]
Abstract
The current medical approach to erectile dysfunction (ED) consists of physiological, psychological and social components. This paper proposes an additional framework for thinking about ED based on phenomenology, by focusing on the theory of sexual projection. This framework will be complementary to the current medical approach to ED. Our phenomenological analysis of ED provides philosophical depth and illuminates overlooked aspects in the study of ED. Mainly by appealing to Merleau-Ponty's Phenomenology of Perception, we suggest considering an additional etiology of ED in terms of a weakening of a function of sexual projection. We argue that sexual projection can be problematized through cognitive interferences, changes in the 'intentional arc', and modifications in the subject's 'body schema'. Our approach further highlights the importance of considering the 'existential situation' of patients with ED. We close by reflecting briefly on some of the implications of this phenomenological framework for diagnosis and treatment of ED.
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Affiliation(s)
- Chris A Suijker
- Department of Urology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
- Faculty of Philosophy, University of Groningen, Groningen, The Netherlands.
| | - Corijn van Mazijk
- Faculty of Philosophy, University of Groningen, Groningen, The Netherlands
| | - Fred A Keijzer
- Faculty of Philosophy, University of Groningen, Groningen, The Netherlands
| | - Boaz Meijer
- Department of Urology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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38
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Dewitte M, Bettocchi C, Carvalho J, Corona G, Flink I, Limoncin E, Pascoal P, Reisman Y, Van Lankveld J. A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM). Sex Med 2021; 9:100434. [PMID: 34626919 PMCID: PMC8766276 DOI: 10.1016/j.esxm.2021.100434] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/16/2021] [Accepted: 08/10/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Although erectile dysfunction (ED) involves an interaction between physiological and psychological pathways, the psychosocial aspects of ED have received considerably less attention so far. AIM To review the available evidence on the psychosocial aspects of ED in order to develop a position statement and clinical practice recommendations on behalf of the European Society of Sexual Medicine (ESSM). METHOD A comprehensive, narrative review of the literature was performed. MAIN OUTCOME MEASURES Specific statements and recommendations according to the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence criteria were provided. RESULTS A multidisciplinary treatment, in which medical treatment is combined with a psychological approach, is preferred over unimodal treatment. There is increasing evidence that psychological treatments of ED can improve medical treatments, the patient's adherence to treatment, and the quality of the sexual relationship. The main components of psychological treatment of ED involve cognitive and behavioral techniques aimed at reducing anxiety, challenging dysfunctional beliefs, increasing sexual stimulation, disrupting sexual avoidance, and increasing intimacy and communication skills in a relational context. When applicable and possible, it is strongly recommended to include the partner in the assessment and treatment of ED and to actively work on interpartner agreement and shared decision-making regarding possible treatment options. To ensure a better integration of the biopsychosocial model into clinical practice, developing concrete treatment protocols and training programs are desirable. CONCLUSION Because the psychosocial approach to ED has been underexposed so far, this position statement provides valuable information for clinicians treating ED. Psychological interventions on ED are based on existing theoretical models that are grounded in empirical evidence. However, the quality of available studies is low, which calls for further research. The sexual medicine field would benefit from pursuing more diversity, inclusivity, and integration when setting up treatments and evaluating their effect. Dewitte M, Bettocchi C, Carvalho J, et al. A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM). Sex Med 2021;9:100434.
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Affiliation(s)
- Marieke Dewitte
- Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.
| | - Carlo Bettocchi
- Policlinic, Urology Unit, University of Aldo Moro, Bari, Italy
| | - Joanna Carvalho
- Escola de Psicologia e Ciências da Vida, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal
| | - Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda USL, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Ida Flink
- Center for Health and Medical Psychology, Örebro University, Örebro, Sweden
| | - Erika Limoncin
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Patricia Pascoal
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, Lisboa, Portugal; Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal; Faculdade de Psicologia e Ciências da Educação & CPUP, Universidade do Porto, Portugal
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Allsop DB, Price AA, Hanna-Walker V, Leavitt CE, Milius EH, Driggs SM. Longitudinal associations between attachment, differentiation of self, and couple sexual and relational outcomes. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.2003320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- David B. Allsop
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Amber A. Price
- School of Family Life, Brigham Young University, Provo, Utah, USA
| | - Veronica Hanna-Walker
- Department of Human Development and Family Studies, University of Connecticut, Storrs, Connecticut, USA
| | | | - Emily H. Milius
- School of Family Life, Brigham Young University, Provo, Utah, USA
| | - Shayla M. Driggs
- School of Family Life, Brigham Young University, Provo, Utah, USA
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40
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Sexual response in obsessive-compulsive disorder: the role of obsessive beliefs. CNS Spectr 2021; 26:528-537. [PMID: 32665050 DOI: 10.1017/s1092852920001649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Sexual response in obsessive-compulsive disorder (OCD) research and practice is overlooked. According to the Dual Control Model, satisfactory sexual response is based upon a balance of sexual excitation and inhibition. The assessment of sexual response in OCD may have clinical implications, such as the integration of sex therapy in psychotherapeutic intervention. The present study was aimed at comparing sexual excitation and inhibition levels between OCD patients and matched control subjects, and investigating whether obsessive beliefs might predict sexual excitation/inhibition. METHODS Seventy-two OCD patients (mean age ± standard deviation [SD]: 34.50 ± 10.39 years) and 72 matched control subjects (mean age ± SD: 34.25 ± 10.18) were included (62.50% men and 37.50% women in both groups). The Obsessive Compulsive Inventory-Revised (OCI-R), the Obsessive Beliefs Questionnaire-46 (OBQ-46), and the Sexual Inhibition/Sexual Excitation Scales (SIS/SES) were administered. RESULTS Patients with OCD showed significantly higher levels of sexual excitation, inhibition due to threat of performance failure, and inhibition due to threat of performance consequences than the controls. In addition, the patients with more severe symptoms showed lower excitation than those with less severe symptoms, and those with higher perfectionism had stronger inhibition due to threat of performance failure than those with lower perfectionism. CONCLUSIONS This is the first study exploring sexual response in OCD according to the Dual Control Model. Sexual response is an impaired quality of life outcome in OCD that should be assessed in routine clinical practice. These findings support the importance of addressing specific obsessive beliefs to improve sexuality in OCD patients.
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Nowosielski K, Kurpisz J, Kowalczyk R, Lew-Starowicz M. Sexual Inhibition and Sexual Excitation Scales in Men: Psychometric Properties of a Polish Adaptation. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2741-2753. [PMID: 32964350 PMCID: PMC8416830 DOI: 10.1007/s10508-020-01837-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 09/06/2020] [Accepted: 09/07/2020] [Indexed: 06/04/2023]
Abstract
The present study aimed to develop a Polish version of the Sexual Inhibition/Sexual Excitation Scale (SIS/SES-PL) and explore its psychometric validity in a sample of 498 men aged between 18 and 55 years. We used exploratory and confirmatory factor analyses to obtain the best model fit. Out of the 45 items in the original scale, 32 items with eight subscales and three higher-order factors: (sexual excitation [SES], sexual inhibition due to performance failure [SIS1], and sexual inhibition due to performance consequences [SIS2]) were included in the SIS/SES-PL. The SIS/SES-PL was found to have a good and satisfactory fit (comparative fit index = .87; Tucker-Lewis Index = .85; root mean square error of approximation = .054; χ2 = 1108.7; p < .001; test-retest reliability Cronbach's alpha = .93). A small correlation between age and the SIS1 and SIS2 scores was detected. However, forward multiple regression analysis revealed a significant correlation only between age and SIS1 [β = .23, p < .001, R2 for model = .05; F(1, 494) = 27.52, p < .001]. Furthermore, a moderate correlation between SIS1 and SES2, as well as SIS1 and general inhibition properties (measured using the Behavioral Inhibition Scale), was noted. In the case of SIS2, only small effects were observed, with the highest values for engaging in risky sexual behavior. Out of the total number of 42 variables, a moderate correlation between SES and the following was described: importance of sex, hypersexual behaviors, frequency of masturbation, frequency of sexual activities per month, sexual risk-taking, high promiscuity (measured using the Sociosexual Orientation Inventory Revised-Drive), general activation properties (measured using the Behavioral Activation Scale), neuroticism, and erotophilic tendencies (measured using the Sexual Opinion Survey-Short Form). The results of the study allowed us to conclude that the SIS/SES-PL might be a useful tool for tailoring therapy for men with sexual problems, as well as in the field of clinical research on sexual inhibition and excitation. Furthermore, it is a reliable and useful tool for measuring propensities for sexual excitement and inhibition.
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Affiliation(s)
| | - Jacek Kurpisz
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Robert Kowalczyk
- Department of Sexology, Andrzej Frycz Modrzewski Cracow University, Kraków, Poland
| | - Michał Lew-Starowicz
- Institute of Psychiatry, Centre of Postgraduate Medical Education, Warsaw, Poland
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Panzeri M, Dadomo H, Ronconi L, Fontanesi L. Validation of the Sexual Inhibition/Sexual Excitation Scales (SIS/SES) in Italy: Assessing Gender and Age Differences of Sexual Functioning. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2755-2772. [PMID: 34363195 PMCID: PMC8416846 DOI: 10.1007/s10508-021-01972-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 06/10/2020] [Accepted: 02/25/2021] [Indexed: 05/29/2023]
Abstract
The Sexual Inhibition Scales and Sexual Excitation Scales (Janssen et al., 2002a), based on the dual control model by Bancroft and Janssen (2000), are part of a 45-item self-report questionnaire evaluating individual tendencies to sexual inhibition or excitation according to three factors: two inhibition factors, SIS1, threat of performance failure, and SIS2, threat of performance consequences, and one excitation factor, SES. In this paper, we aimed to validate and explore psychometric properties of the SIS/SES in a sample of 2260 Italian men and women aged 18 to 75 years. Confirmatory factor analyses showed that the three-factor structure proposed in the original version of the scales fit with our sample. Moreover, our data confirmed the results of the original validation sample: Women scored higher on the SIS and lower on the SES than men did, but no significant differences appeared in the factor scores by age group, except for a gender × age interaction, where younger women had higher SIS2 scores. The SIS/SES appeared to be an effective, appropriate cross-cultural measurement of human sexuality in Italian samples, also shedding light on sexual arousal differences in women and men in our country. We also discuss clinical and therapeutic aspects.
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Affiliation(s)
- Marta Panzeri
- Department of Developmental Psychology and Socialisation, Università Degli Studi di Padova, via Venezia 8, 35131, Padua, Italy.
| | - Harold Dadomo
- Unity of Neuroscience, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Lucia Ronconi
- FISPPA, Università degli studi di Padova, Padua, Italy
| | - Lilybeth Fontanesi
- Department of Psychological, Humanistic and Territorial Sciences, University of Chieti, Chieti, Italy
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43
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Nolet K, Emond FC, Pfaus JG, Gagnon J, Rouleau JL. Sexual Attentional Bias in Young Adult Heterosexual Men: Attention Allocation Following Self-Regulation. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2531-2542. [PMID: 34268658 DOI: 10.1007/s10508-021-01928-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 01/14/2021] [Accepted: 01/19/2021] [Indexed: 06/13/2023]
Abstract
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.
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Affiliation(s)
- Kevin Nolet
- Laboratoire de Cyberpsychologie de L'UQO, Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Succ. Hull, 283 Boul. Alexandre-Taché, 2e étage, local C-2500, C.P. 1250, Gatineau, QC, J8X 3X7, Canada.
| | | | - James G Pfaus
- Centro de Investigaciones Cerebrales, Universidad Veracruzana, Xalapa de Enríquez, VER, México
| | - Jean Gagnon
- Département de Psychologie, Université de Montréal, Montréal, QC, Canada
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Velten J, Milani S, Margraf J, Brotto LA. Visual attention and sexual arousal in women with and without sexual dysfunction. Behav Res Ther 2021; 144:103915. [PMID: 34174705 DOI: 10.1016/j.brat.2021.103915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 05/01/2021] [Accepted: 06/09/2021] [Indexed: 11/25/2022]
Abstract
Attention to sexual stimuli is a prerequisite to process such stimuli as sexually-meaningful and is an important means to facilitate sexual arousal. Attending to sexual cues is crucial for healthy sexual functioning. Studies suggest that sexual dysfunction is associated with less attention towards sexual stimuli. The goal of this study was to use an eye-tracking-based free-viewing paradigm to investigate whether women with sexual dysfunction visually attend to the genital area in dynamic sexual stimuli (i.e., erotic videos) differently than women with subclinical sexual function or those with typical sexual functioning. A total of 69 women (Mage = 27.77, SD = 8.00) with clinical (n = 30), subclinical (n = 23), and typical (n = 16) levels of sexual functioning watched four 1-min video clips depicting heterosexual couples engaging in vaginal intercourse or cunnilingus while the total fixation duration on the genital area as well as their subjective and genital sexual arousal were recorded. As hypothesized, the clinical group fixated on the genital area less than women with typical sexual functioning. A longer total fixation duration on the genital area was followed by increases in subjective arousal and genital arousal. The relationship between attention and arousal was not moderated by sexual functioning group. This study provides first evidence of the role of sustained visual attention for facilitating sexual arousal in women with and without sexual dysfunction.
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Affiliation(s)
- Julia Velten
- Mental Health Research and Treatment Center, Department of Clinical Psychology and Psychotherapy, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany.
| | - Sonia Milani
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada.
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Department of Clinical Psychology and Psychotherapy, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany.
| | - Lori A Brotto
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada.
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45
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Nolet K, Guay JP, Bergeron S. Validation of the French-Canadian Version of the Sexual Inhibition and Sexual Excitation Scales-Short Form (SIS/SES-SF): Associations With Sexual Functioning, Sociosexual Orientation, and Sexual Compulsivity. Sex Med 2021; 9:100374. [PMID: 34091418 PMCID: PMC8360913 DOI: 10.1016/j.esxm.2021.100374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/17/2021] [Accepted: 03/23/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction The Dual control model proposes that both excitatory and inhibitory processes are responsible for the human sexual response. Aim To validate the French-Canadian translation of the Sexual Inhibition and Excitation Scales-Short Form (SIS/SES-SF) by exploring its factor structure and by investigating its capacity to retrospectively predict sexual functioning and behaviors, namely, sociosexual orientation and sexual compulsivity. Methods A French-Canadian translation of the SIS/SES-SF was created using forward-backward translation. A community sample of 362 men and 420 women completed an online survey. The factor structure and the measurement invariance between men and women was explored using Exploratory Structural Equation Modeling. Predictive power of the scales was tested using Multiple Linear Regression models using a corrected threshold (P< .008). Main outcome measures Sexual functioning was assessed using the International Index of Erectile Function and the Female Sexual Function Index while sexual compulsion and sociosexual orientation were measured using the Sexual Compulsion Scale and the Revised Sociosexual Orientation Inventory, respectively. Results The original three-factor solution of the SIS/SES-SF was replicated. All three scales showed acceptable internal consistency and good temporal stability. Yet, results only supported configural measurement invariance between men and women, suggesting that their scores cannot be directly compared. Overall, for both men and women, higher sexual excitation (SES) was significantly predictive of better sexual functioning, while higher sexual inhibition due to threat of performance failure (SIS1) was a significant predictor of lower sexual functioning. Both sexual compulsivity and sociosexual orientation were significantly predicted by higher SES and lower sexual inhibition due to threat of performance consequences (SIS2). Conclusion These results support the cross-cultural transferability of the SIS/SIS-SF and the Dual control model to French-Canadian men and women, higlighting the utility for clinicians to evaluate both excitatory and inhibitory factors associated with sexual dysfunction and sexual behaviors. Nolet K, Guay JP, Bergeron S. Validation of the French-Canadian Version of the Sexual Inhibition and Sexual Excitation Scales-Short Form (SIS/SES-SF): Associations With Sexual Functioning, Sociosexual Orientation, and Sexual Compulsivity. Sex Med 2021;9:100374.
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Affiliation(s)
- Kévin Nolet
- Université du Québec en Outaouais, Département de psychoéducation et de psychologie, Gatineau, Québec, Canada.
| | - Jean-Pierre Guay
- Université de Montréal, École de criminologie, Montréal, Québec, Canada
| | - Sophie Bergeron
- Université de Montréal, Département de psychologie, Montréal, Québec, Canada
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Skakoon-Sparling S, Milhausen RM. Sexual Excitation and Sexual Inhibition in the Context of Sexual Risk-Taking. JOURNAL OF SEX RESEARCH 2021; 58:671-680. [PMID: 32600069 DOI: 10.1080/00224499.2020.1776820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The current study examined the roles of sexual excitation and sexual inhibition in the context of sexual risk-taking among heterosexual women and men to better understand the link between sexual arousal and sexual risk-taking. We set out to determine which factors in the Sexual Excitation and Sexual Inhibition Inventory for women and men (SESII-W/M) were most predictive of sexual response and sexual risk-taking behavior. Participants (N = 266, women = 166) completed the SESII-W/M instrument and responded to items assessing their sexual risk-taking intentions and their risk-taking indicators. A sub-sample (n = 133, women = 83) also completed a sexual arousal manipulation. Sexual excitation was linked with higher levels of self-reported sexual arousal (among women and men) and greater risk-taking intentions (among women only). However, controlling for gender, sexual inhibition was a better predictor of sexual risk-taking intentions, compared to sexual excitation. The Dual Control Model offers unique insights into conceptualizations of sexual response to erotic stimuli and behavioral risk-taking. These findings can inform more effective interventions to promote risk reduction through sex positive approaches that capitalize on the pleasure enhancing capabilities of safer sex strategies.
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Affiliation(s)
| | - R M Milhausen
- Family Relations and Applied Nutrition, University of Guelph
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Rousseau A, Bőthe B, Štulhofer A. Theoretical Antecedents of Male Adolescents' Problematic Pornography Use: A Longitudinal Assessment. JOURNAL OF SEX RESEARCH 2021; 58:331-341. [PMID: 32902343 DOI: 10.1080/00224499.2020.1815637] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Although considerable research has examined the antecedents of adolescents' pornography use (PU), little data exist on the underlying mechanisms of problematic pornography use (PPU) in adolescence. To bridge this gap, the current longitudinal study examined the long-term associations between adolescent boys' PU frequency, PPU, and theory-based predictors of PPU. Testing three conceptual models (the moral incongruence, out of control, and mood management models), we examined the relative contributions of impulsivity, depression/anxiety symptoms, and religiosity to PPU, controlling for PU over time. The analysis was conducted using a panel sample of 337 Croatian men (Mage = 15.9 years, SD = 0.52). Latent growth curve modeling showed that baseline levels of, and subsequent growth in PU predicted later higher levels of PPU, irrespective of participants' religiosity, negative emotions, and impulsivity. Baseline higher levels of negative emotions and impulsivity predicted higher levels of PPU three years later, even after controlling for the growth in PU over time. Religiosity moderated the association between changes in PU and PPU. Growth in PU resulted in higher PPU among more religious adolescents, compared to their less religious peers. This study's findings support all three conceptual models explaining PPU in adults and may guide clinical work with adolescents seeking help for PPU.
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Affiliation(s)
- Ann Rousseau
- School for Mass Communication Research, KU Leuven
| | - Beáta Bőthe
- Département de Psychologie, Université de Montréal
| | - Aleksandar Štulhofer
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb
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Pawłowska A, Borg C, de Jong PJ. Up-regulating Sexual Arousal and Down-regulating Disgust while Watching Pornography: Effects on Sexual Arousal and Disgust. JOURNAL OF SEX RESEARCH 2021; 58:353-363. [PMID: 33378217 DOI: 10.1080/00224499.2020.1863316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Sexual response occurs when sexual excitatory factors outweigh inhibitory factors. Problems with sexual arousal may occur when sexual excitation is too low and/or inhibitory influences such as feelings of disgust are too strong. To explore interventions that may help overcome decreased sexual responding, we examined if sexual responding could be amplified by instructions to up-regulate sexual arousal and/or down-regulate disgust. Women with no sexual difficulties (N = 255; µage = 20.55; SD = 2.23) were randomly assigned to a sexual arousal up-regulation, disgust down-regulation, or passive control condition. Participants were instructed to use the assigned regulation strategy while viewing pornography. To prevent floor effects due to low disgust responsivity in a non-clinical sample, half of the participants were presented with a prime that was designed to make the contaminating properties of sex more salient. Instruction to up-regulate sexual arousal successfully enhanced feelings of sexual arousal in the unprimed group, yet the increase in sexual arousal was not paralleled by reductions in feelings of disgust. Instruction to down-regulate disgust successfully decreased disgust; however, this decrease was not paralleled by increases in sexual arousal. Overall, findings indicate that emotion regulation techniques could facilitate affective control in sexual contexts.
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Affiliation(s)
- Aleksandra Pawłowska
- Department of Clinical Psychology & Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen
| | - Charmaine Borg
- Department of Clinical Psychology & Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen
| | - Peter J de Jong
- Department of Clinical Psychology & Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen
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Rodríguez-Nieto G, Sack AT, Dewitte M, Emmerling F, Schuhmann T. The Modulatory Role of Cortisol in the Regulation of Sexual Behavior in Young Males. Front Behav Neurosci 2020; 14:552567. [PMID: 33250723 PMCID: PMC7674834 DOI: 10.3389/fnbeh.2020.552567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/07/2020] [Indexed: 11/13/2022] Open
Abstract
The proneness to be sexually aroused, to perform sexual acts, or to be sexually disinhibited during a particular mood varies across individuals. However, the physiological mechanisms underlying this specific and variable relationship between mood and sex-related processes are poorly understood. We propose that cortisol may act as an important moderator in this as it has shown to influence sexual arousal and to play a neuromodulatory role during emotion regulation. Here, we conducted a functional magnetic resonance imaging study in a sample of young males to investigate whether cortisol modulates the neural response during the approach of sexual stimuli in an approach-avoidance task and whether this potential relationship explains the individual differences in sexual inhibition and in mood-related sexual interest and activity. We revealed that cortisol associates with the anteromedial prefrontal cortex activation during the approach towards sexual stimuli. Moreover, this anteromedial prefrontal cortex response was dependent on individual differences in sexual inhibition and the improvements of negative mood as a result of sexual activity. The anteromedial prefrontal cortex is already known to process bottom-up information, reward, and risk estimation. The neuromodulatory role of cortisol within this region during sexual approach may represent a previously unknown yet key element in the regulation of sexual behavior in young males.
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Affiliation(s)
- Geraldine Rodríguez-Nieto
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.,Department of Movement Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Alexander T Sack
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Marieke Dewitte
- Department of Clinical Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Franziska Emmerling
- Chair of Research and Science Management, Technical University of Munich, Munich, Gemany
| | - Teresa Schuhmann
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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Borg C, Pawłowska A, van Stokkum R, Georgiadis JR, de Jong PJ. The Influence of Sexual Arousal on Self-Reported Sexual Willingness and Automatic Approach to Models of Low, Medium, and High Prior Attractiveness. JOURNAL OF SEX RESEARCH 2020; 57:872-884. [PMID: 31729895 DOI: 10.1080/00224499.2019.1687641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Anecdotal evidence suggests that sexual attraction is flexible, and that high levels of sexual arousal can promote sexual willingness and approach tendencies toward a priori low attractive mates. This experimental study tested whether heightened sexual arousal can lower the threshold for sexual willingness and automatic approach tendencies toward potential sex partners of low and medium attractiveness. Heterosexual male (n =54) and female (n =61) participants were randomly assigned to a sexual arousal or control condition. Approach tendencies were indexed using a reaction time task. Sexual willingness was indexed using participant ratings of willingness to kiss and to consider having sex with same- and other-sex models of low, medium, and high attractiveness. Overall, participants showed stronger approach to models of high and medium than of low attractiveness. Sexual arousal weakened this differential responding but did not result in a robust increase of approach toward less attractive other-sex or same-sex models. Sexual willingness toward less attractive models was not affected by sexual arousal. Independent of condition, women reported greater sexual willingness toward same-sex models. The current pattern of findings does not support the notion that sexual arousal promotes automatic approach and sexual willingness to a broader array of sex partners.
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Affiliation(s)
- Charmaine Borg
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen
| | - Aleksandra Pawłowska
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen
| | - Robin van Stokkum
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen
| | - Janniko R Georgiadis
- Department of Biomedical Sciences of Cells & Systems / Section Anatomy & Medical Physiology, University of Groningen, University Medical Center Groningen
| | - Peter J de Jong
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen
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