Conscious regulation of sexual arousal in men

The Dual Control Model of Sexual Response: A Scoping Review, 2009-2022

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.

A Test of Three Different Explanations for Low Stimulus Response Discrimination in Phallometric Testing

Phallometric assessment is used to assess men's sexual interest in children and to assist in risk assessment and treatment planning. A common response pattern, especially when the assessment is conducted in a forensic context, is an indiscriminate pattern of penile responses: No sexual stimulus seems to produce a substantially higher response than another. This indiscriminate response profile could be the result of (1) faking good (in particular, reducing the responses to child stimuli); (2) floor or ceiling effects caused by low or high arousability, or (3) non-exclusivity (the individual is similarly sexually interested in both children and adults). In this study of 2,858 adult male patients who underwent volumetric phallometric assessment for sexual interest in children between 1995 and 2011, we tested these three possible explanations. Results showed support for each of the explanations, but the variance accounted for in response discrimination was quite small when considering each explanation (separately or when considered together). We discuss avenues for future research to better discern the causes of indiscriminate responding in phallometric assessment.

The Interplay of Sexual Arousal and Power-Related Emotions in Men's Alcohol-Involved Sexual Aggression Intentions

Research has identified power/dominance and sexual arousal as key motivators of men's sexual aggression; however, little research has examined the interplay of these two factors in alcohol-involved sexual aggression. Two alcohol administration experiments investigated the roles of power-related sex motives and power- and sexual arousal-related emotions on men's sexual aggression intentions. In Study 1, participants (N = 96) read a sexual aggression scenario after random assignment to consume either an alcoholic (target peak BrAC = .10%) or nonalcoholic beverage. Results indicated that power-related sex motives indirectly predicted stronger sexual aggression intentions through greater in-the-moment power-related emotions but not through sexual arousal-related emotions. Intoxicated men with more severe perpetration histories reported stronger sexual aggression intentions. In Study 2, participants (N = 203) completed similar measures after random assignment to receive either a brief emotion regulation-focused intervention (cognitive restructuring or mindfulness) or a control, followed by either alcohol (target peak BrAC = .08%) or nonalcoholic beverage consumption. Results demonstrated that greater power-related sex motives indirectly predicted stronger sexual aggression intentions through greater feelings of power and sexual arousal. Additionally, findings suggest that cognitive restructuring approaches may mitigate these relationships in sober men, while mindfulness approaches may exacerbate these relationships in intoxicated men.

Emotion Regulation by Psychological Distance and Level of Abstraction: Two Meta-Analyses

Self-reflection is suggested to attenuate feelings, yet researchers disagree on whether adopting a distant or near perspective, or processing the experience abstractly or concretely, is more effective. Given the relationship between psychological distance and level of abstraction, we suggest the "construal-matching hypothesis": Psychological distance and abstraction differently influence emotion intensity, depending on whether the emotion's appraisal involves low-level or high-level construal. Two meta-analyses tested the effects of psychological distance (k = 230) and level-of-abstraction (k = 98) manipulations on emotional experience. A distant perspective attenuated emotional experience (g = 0.52) but with weaker effects for high-level (g = 0.29; for example, self-conscious emotions) than low-level emotions (g= 0.64; for example, basic emotions). Level of abstraction only attenuated the experience of low-level emotions (g = 0.2) and showed a reverse (nonsignificant) effect for high-level emotions (g = -0.13). These results highlight differences between distancing and level-of-abstraction manipulations and the importance of considering the type of emotion experienced in emotion regulation.

The Relationship Between Emotion Regulation and Sexual Function and Satisfaction: A Scoping Review

INTRODUCTION

Sexual problems are characterized by difficulties in the ability to respond sexually or to obtain sexual pleasure. Their etiology is assumed to be multifactorial, demanding a biopsychosocial treatment approach. Positive sexual experiences involve the dynamic interplay between cognitive, emotional, and motivational factors. Difficulties in emotion identification or impairment in emotion regulation may thus play a pivotal role in the development and maintenance of sexual problems.

OBJECTIVES

To conduct a scoping review of the literature on the effects of emotion regulation on sexual function and satisfaction.

METHODS

We conducted a scoping review using Cinahl, Lilacs, Scielo, Scopus, PsycInfo and Pubmed electronic databases using search terms related to emotion regulation and sexual function and satisfaction.

RESULTS

27 articles met the inclusion criteria and were further analyzed. Overall, emotion regulation difficulties were associated with poorer sexual health outcomes, difficulties in the sexual response cycle and overall lower sexual satisfaction. Laboratory studies and intervention trials found positive effects of promoting emotion regulation change on sexual function and satisfaction.

CONCLUSIONS

Despite the methodological diversity of studies, it can be concluded from this review that difficulties in emotion regulation are related to sexual difficulties and sexual dissatisfaction. Future research should consider emotion regulation-focused interventions to mitigate sexual health problems.. Fischer VJ, Andersson G, Billieux J, et al. The Relationship Between Emotion Regulation and Sexual Function and Satisfaction: A Scoping Review. Sex Med Rev 2021;XX:XXX-XXX.

The Impact of Sexual Arousal and Emotion Regulation on Men's Sexual Aggression Proclivity

Extant literature supports a relationship between sexual arousal and increased likelihood of sexually coercive behavior in men. The present study investigated the impact of sexual arousal on sexual coercion proclivity and the degree to which emotion regulation moderated this relationship in the context of two separate affect inductions. We predicted that sexual arousal would more strongly predict sexual coercion likelihood for men scoring lower on emotion regulation ability compared with men with above average emotion regulation abilities. Male participants with (n = 38) and without (n = 40) self-reported histories of sexual coercion were recruited from urban sexually transmitted infection testing clinics. Participants completed a measure of emotion regulation, underwent a positive and negative affect induction, viewed an erotic video, and reported on their level of sexual arousal immediately prior to completing a hypothetical sexual coercion likelihood laboratory task. Relationships between emotion regulation, sexual arousal, and sexual coercion likelihood were examined using moderation analyses. Sexual arousal was associated with greater reported sexual coercion likelihood. For men with poorer emotion regulation, sexual arousal significantly and positively predicted sexual coercion likelihood in the positive affect condition. Sexual arousal did not significantly predict sexual coercion for men with above average emotion regulation. Findings may have implications for the assessment of individual risk for coercive sexual behavior as well as primary prevention efforts.

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

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

Alcohol-involved sexual aggression: Emotion regulation as a mechanism of behavior change

OBJECTIVE

Sexual aggression remains a significant public health problem, with the majority of sexual assaults involving alcohol. Founded upon an experimental medicine approach to behavior change, the current study used a proximal change experiment to target and test emotion regulation (ER) as a mechanism underlying alcohol-involved sexual aggression.

METHOD

Heavy episodic drinking men aged 21-30 with a sexual assault perpetration history (N = 209) were randomly assigned to a brief, online, ER-focused cognitive restructuring or mindfulness intervention or to control. Intervention effects were evaluated during sober and intoxicated states through laboratory-based alcohol administration (target BrAC = .08%). Intoxicated and sober participants completed a proximal change protocol that included implementing ER skills during a sexual aggression analogue that assessed relevant emotions and intentions.

RESULTS

Path analysis demonstrated that relative to control, the cognitive restructuring intervention improved emotional modulation and emotional clarity, resulting in lower sexual arousal and anger, respectively, followed by decreased sexual coercion intentions. The mindfulness intervention yielded mixed results, predicting decreased sexual aggression intentions compared to control but also predicting stronger coercive tactic intentions in intoxicated men with more severe sexual aggression histories. Both interventions improved emotional acceptance relative to control, but only for sober men.

CONCLUSIONS

Overall, the current study demonstrated that ER-focused interventions improved proximal ER skills associated with reduced sexual aggression intentions, signifying ER as an important mechanism for changing sexually aggressive behavior. Because intervention efficacy varied by intoxication state, further research is needed to assess the effectiveness of ER interventions targeting real-world alcohol-involved sexual aggression. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Coping Using Sex During the Coronavirus Disease 2019 (COVID-19) Outbreak in the United Kingdom

BACKGROUND

The use of sex to cope with negative affective states during the coronavirus disease 2019 (COVID-19) pandemic may be influenced by various sociodemographic and psychological characteristics.

AIM

We aimed to examine the effects of social distancing, loneliness, difficulties in emotion regulation, and self-regulation on participants self-reported coping using sex during lockdown in the United Kingdom.

METHODS

Participants had to be residents of the United Kingdom, aged between 18-60 years, fluent in English, and had to have an Internet connection. They were instructed not to participate if they had consumed alcohol in the previous 24 hours. A total of 789 participants aged 18-59 years completed an online survey. Participants provided self-report measures of social distancing, loneliness, and difficulties in emotion regulation. A Go/No-Go task was used to assess self-regulation.

OUTCOMES

Participants self-reported their use of sex to cope over a 14-day period during lockdown, as well as retrospectively for a 14-day period immediately preceding lockdown. Coping using sex items included consensual and non-consensual themes.

RESULTS

Overall, there was no increase in coping using sex during lockdown compared with before lockdown. Findings showed that 30% of participants reported increased coping using sex during lockdown compared with before, 29% reported decreased coping using sex, and 41% reported no change. All regression models included age, gender, ethnicity, diagnosis of psychiatric condition, level of education, being at high-risk for difficulties relating to COVID-19, living alone, and diagnosed or suspected COVID-19 as covariates. Being younger, being male, and greater emotion dysregulation were associated with higher coping using sex total and consent subscale scores during lockdown. Being younger, being male, not living alone, and less adherence to social distancing advice were associated with coping using sex with a theme of rape/violence during lockdown.

CLINICAL TRANSLATION

A proportion of participants used sex to cope more often during lockdown compared with before. Less adherence to social distancing advice and emotion dysregulation were associated with using sex to cope during lockdown.

STRENGTHS & LIMITATIONS

Strengths of this study were the large sample size and inclusion of key sociodemographic characteristics as covariates. The main limitations were the cross-sectional design and a sample that was mostly white, educated, and female.

CONCLUSION

Participants who had difficulty regulating emotions were more likely to use sex to cope. It is important that support is available for people who have problems regulating their emotions during the pandemic and that they have access to appropriate help and advice. Gillespie SM, Jones A, Uzieblo K, et al. Coping Using Sex During the Coronavirus Disease 2019 (COVID-19) Outbreak in the United Kingdom. J Sex Med 2021;18:50-62.

Validación de las Escalas de Inhibición y Excitación Sexual (SIS/SES-SF) en colombianos

Las escalas SIS/SES-SF han sido desarrolladas para medir la inhibición y la excitación sexual. El objetivo del presente estudio fue adaptar y validar estas escalas en población colombiana. Para esto, se realizó la adaptación cultural y validación de contenido de las escalas por medio del juicio de siete expertos, y se validaron psicométricamente sobre una muestra de 2125 participantes (1000 hombres y 1125 mujeres). Los hombres contestaron al International Index of Erectile Function y la Premature Ejaculation Diagnostic Tool; mientras que el total de la muestra contestó al Sexual Desire Inventory, al Massachusetts General Hospital-Sexual Functioning Questionnaire y a la Sexual Inhibition/Sexual Excitation Scales-Short Form, todo ello junto a una batería sociodemográfica. El muestreo se realizó de forma virtual a través de Facebook. Los índices de las escalas mostraron una apropiada validez y fiabilidad. Además, para ambos sexos, las escalas mostraron un nivel de invarianza estricto. Las relaciones significativas con las otras medidas dan cuenta de su validez de criterio. Se sugiere el uso del instrumento para continuar con la investigación del Modelo de Control Dual dentro de la sexualidad en Latinoamérica.

Prevalence of Shukra vega dharana in an Indian population: A cross sectional survey protocol

BACKGROUND

Despite being an important aspect of health and quality of life, individuals tend to suppress natural sexual urge ('Shukra vega') due to a variety of factors. Unless managed appropriately through self-regulatory mechanisms, suppressed sexual urge ('Shukra vega dharana', SVD) not only causes psychological suffering but may also put other basic needs at risk. Adult, married, males who are either living away from their spouse for long durations or separated or divorced are at a considerably higher risk of developing SVD as compared to others. Considering the recent rise of sexual diseases and sexual violence, it is critical to understand the extent and epidemiology of SVD in this sub-population of India.

OBJECTIVE

The study was attempted to understand the extent and epidemiology of SVD in this sub-population of India.

MATERIALS AND METHODS

To determine the prevalence of SVD in adult married, male individuals located in Nashik, Ahmadnagar and Thane cities of India who are either living away from their spouse or separated or divorced, a crosssectional, anonymous survey will be conducted among a sample of male individuals meeting eligibility criteria. A multi-stage sampling approach will be used to identify cities/organizations (where the study will be conducted) and participants for the study. Post informed consent, eligible individuals will respond to a survey questionnaire. Responses will be populated in a spreadsheet, analyzed and reported. Understanding extent and epidemiology of SVD in an Indian sub-population will not only facilitate design of future research studies but will also inform health, social and educational policy associated with sex education (training individuals in the appropriate management of sexual urge).

Perceived ability to regulate love

Research has shown that romantic love can be regulated. We investigated perceptions about love regulation, because these perceptions may impact mental health and influence love regulation application. Two-hundred eighty-six participants completed a series of items online via Qualtrics that assessed perceived ability to up- and down-regulate, exaggerate and suppress the expression of, and start and stop different love types. We also tested individual differences in perceived love regulation ability. Participants thought that they could up- but not down-regulate love in general and that they could up-regulate love in general more than down-regulate it. Participants thought that they could up-regulate infatuation less than attachment and sexual desire. Participants also thought that they could exaggerate and suppress expressions of infatuation, attachment, and sexual desire, but that they could not start and stop infatuation and attachment, or start sexual desire. The more participants habitually used cognitive reappraisal, the more they thought that they could up- and down-regulate infatuation and attachment and up-regulate sexual desire. The more participants were infatuated with their beloved, the more they thought that they could up- but not down-regulate infatuation, attachment, and sexual desire. Finally, participants thought that they could up- and down-regulate happiness more than infatuation These findings are a first step toward the development of psychoeducation techniques to correct inaccurate love regulation perceptions, which may improve mental health and love regulation in daily life.

Sexual Well-Being in Older Women: The Relevance of Sexual Excitation and Sexual Inhibition

The aim of this study was to use the dual control model of sexual response (DCM) to investigate variation in sexual well-being among women 50 years of age and older. Data from 185 women 50 years of age and older (M = 59.46, SD = 6.96) were used to examine the relationships between sexual excitation (SE) and sexual inhibition (SI) and their lower-order factors to indicators of sexual well-being (i.e., sexual functioning, satisfaction, distress, frequency of sexual activity, and breadth of sexual behavior). Possible moderating factors were also explored. Independently, SE and SI were associated with the majority of the indicators of sexual well-being, and the directions of associations were consistent with the tenets of the DCM. SE and SI lower-order factors were significant predictors of sexual function, satisfaction, and frequency of sexual activity. Sexual distress was predicted more strongly by SI factors and breadth of sexual behavior by one SE lower-order factor (arousability). Partner physical and mental health and participant's own mental health were identified as moderating variables of these associations. Findings of this study are discussed considering the contribution of the DCM to understanding the role of diversity in older women's sexual well-being.

Problematic internet pornography use: The role of craving, desire thinking, and metacognition

Defined as sexually explicit material that elicits erotic thoughts, feelings, and behaviours, internet pornography is a prevalent form of media that may facilitate problematic use and craving for engagement. Research suggests that superordinate cognitions and information processing, such as desire thinking and metacognition, are central to the activation and escalation of craving in addictive behaviours. The current study aimed to contribute to the literature by testing the proposed metacognitive model of desire thinking and craving in a sample of problematic pornography users, while revising the model by incorporating negative affect. From a theoretical perspective, environmental cues trigger positive metacognitions about desire thinking that directly influence desire thinking, resulting in the escalation of craving, negative metacognitions, and negative affect. Participants were recruited via an online survey and screened for problematic internet pornography use. Path analyses were used to investigate relationships among the aforementioned constructs in a final sample of 191 participants. Consistent with previous research, results of this study validated the existence of metacognitive processes in the activation of desire thinking and escalation of craving, while indicating that desire thinking has the potential to influence negative affect. Additionally, results supported the role of significant indirect relationships between constructs within the revised model of metacognition, desire thinking, and psychopathology. Collectively, the findings demonstrate the clinical value of a metacognitive conceptualisation of problematic pornography use. Exploring the metacognitive mechanisms that underpin problematic internet pornography use may give rise to the development of new treatment and relapse prevention strategies.

Gender-Specificity in Viewing Time Among Heterosexual Women

Measures of sexual interest tend to be more gender-specific in heterosexual men than in heterosexual women. Cognitive measures, such as viewing time to attractive stimuli, may also show similar patterns of gender-specificity or nonspecificity among men and women and thus serve as useful adjuncts to more direct measures of sexual interest. The objectives of the present research were to determine the extent of gender-specificity in women's viewing times for female pictures (varying in their perceived physical attractiveness) and explore the influence of social comparison of physical appearance on these patterns of responses. In Study 1, we recorded only women's viewing times for pictures of both genders, measured self-reported menstrual cycle phase, and manipulated the waist-to-hip ratio of the women in the female pictures. In Study 2, we recorded women's and men's viewing times, self-reported sexual attraction to pictures of males and females, and physical appearance social comparison. Study 1 found that heterosexual women's viewing time toward female pictures was not associated with manipulation of the perceived attractiveness of those pictures. Study 2 found that heterosexual men were more gender-specific than heterosexual women in their viewing time patterns. We also found that reported sexual attraction and physical appearance social comparison were associated with heterosexual women's viewing times for female pictures, while heterosexual men's viewing times were associated with sexual attraction only. Our results are discussed in relation to the utility of viewing time as an indicator of visual attention toward attractive or sexually appealing visual stimuli.

Inhibiting Sexual Arousal to Children: Correlates and Its Influence on the Validity of Penile Plethysmography

The current study examined the extent to which 1136 men were able to inhibit their sexual arousal on a phallometric assessment, when instructed to do so. Although the observed changes between the two conditions (i.e., Normal and Suppression) were small to moderate in magnitude, the change was not more than what would be expected by measurement error for most participants (e.g., 83% of pedophilic sex offenders against children did not successfully inhibit their sexual arousal in the Suppression condition). There were very few variables that were associated with the ability to suppress. Higher Pedophilia Index scores in the Suppression condition predicted a greater likelihood of sexual recidivism among sex offenders (hazard ratio = 1.17, 95% CI [1.04, 1.32]), but the ability to suppress sexual arousal was not found to predict sexual recidivism. The current study highlights the importance of accounting for measurement error and found that, when doing so, most sex offenders against children are unable to successfully inhibit their sexual arousal to children when instructed to do so, and that the ability to suppress sexual arousal is not associated with recidivism.

Sexual Desire Inventory: Two or Three Dimensions?

The Sexual Desire Inventory (SDI), developed by Spector, Carey, and Steinberg in 1996, has been widely used to assess sexual desire in men and women throughout the world. This questionnaire categorizes sexual desire in two dimensions: dyadic sexual desire and solitary sexual desire. Our study addressed the factorial structure of the SDI, an aspect that until now has been largely neglected. We recruited two samples of Spanish men and women involved in stable heterosexual relationships. The first sample consisted of 3,417 subjects (1,600 males and 1,817 females), ages 18 to 84; the second sample consisted of 677 subjects (285 males and 392 females), ages 18 to 50. The results of an exploratory factor analysis (EFA) showed that instead of two dimensions the SDI should have three: (1) partner-focused dyadic sexual desire, (2) general dyadic sexual desire for an attractive person, and (3) solitary sexual desire. A confirmatory factor analysis (CFA) supported the robustness of this new three-factor structure. No gender differences were revealed, except for dyadic sexual desire for an attractive person, for which men reported higher scores. Good validity and reliability values were obtained. Moreover, standard scores for men and women by different age groups were developed.

Using the Dual Control Model to Investigate the Relationship Between Mood, Genital, and Self-Reported Sexual Arousal in Men and Women

Recent findings suggest that there is considerable interindividual variability in how mood affects sexual arousal and that the dual control model may be helpful in explaining this variation. The current research investigated whether mood interacted with sexual excitation and inhibition proneness to predict subjective and genital arousal. In this study, 33 participants (18 men; 15 women), ages 18 to 45, attended three laboratory sessions where they completed questionnaires assessing preexisting mood and propensity for sexual excitation and inhibition, then watched a series of neutral and sexually explicit films. Subjective sexual arousal was continuously indicated during each film, while genital temperature was measured using thermographic imaging. Sexual excitation and inhibition interacted with various mood scores to significantly predict both subjective and genital arousal in men and women. Several gender differences were found. For example, vigor scores interacted with sexual excitation proneness to significantly predict genital but not subjective arousal in women, while the same interaction significantly predicted subjective but not genital arousal in men. The findings supported the hypothesis that the dual control model is an important framework in understanding how mood influences both subjective and genital sexual arousal.

How Ego Depletion Affects Sexual Self-Regulation: Is It More Than Resource Depletion?

Rational thinking and decision making are impacted when in a state of sexual arousal. The inability to self-regulate arousal can be linked to numerous problems, like sexual risk taking, infidelity, and sexual coercion. Studies have shown that most men are able to exert voluntary control over their sexual excitation with various levels of success. Both situational and dispositional factors can influence self-regulation achievement. The goal of this research was to investigate how ego depletion, a state of low self-control capacity, interacts with personality traits-propensities for sexual excitation and inhibition-and cognitive absorption, to cause sexual self-regulation failure. The sexual responses of 36 heterosexual males were assessed using penile plethysmography. They were asked to control their sexual arousal in two conditions, with and without ego depletion. Results suggest that ego depletion has opposite effects based on the trait sexual inhibition, as individuals moderately inhibited showed an increase in performance while highly inhibited ones showed a decrease. These results challenge the limited resource model of self-regulation and point to the importance of considering how people adapt to acute and high challenging conditions.

The Relationship Between Hypersexual Behavior, Sexual Excitation, Sexual Inhibition, and Personality Traits

The term hypersexuality was introduced to describe excessive sexual behavior associated with a person's inability to control his or her sexual behavior. The main aim of the present study was to investigate the impact of different personality traits on the degree of hypersexual behavior as measured by the Hypersexual Behavior Inventory (HBI). A further aim was to evaluate the association between sexual inhibition and excitation [as described in the Dual Control Model (DCM)] and hypersexual behavior. A sample of 1,749 participants completed an internet-based survey comprised the HBI, the short form of the Sexual Inhibition/Sexual Excitation Scales (SIS/SES-SF) as well as more general personality measures: the Behavioral Inhibition System/Behavioral Activation System-scales (BIS/BAS-scales) and a short version of the Big Five Inventory (BFI-10). Using the recommended HBI cut-off, 6.0 % (n = 105) of the present sample could be categorized as hypersexual, which is comparable to the results of previous studies about the prevalence of hypersexual behavior in the general population. The results provided strong support for the components of the DCM-sexual excitation and inhibition-to explain hypersexual behavior, irrespective of gender and sexual orientation. Some of the general personality traits also showed significant relationships with hypersexual behavior. Taken together, the results of the present study provide further support for the relevance of research about the relationships between sexual problems and disorders, the DCM, and personality variables.

Modulation of late positive potentials by sexual images in problem users and controls inconsistent with "porn addiction"

"Excessive" viewing of visual sexual stimuli (VSS) is the most commonly reported hypersexual behavior problem and is especially amenable to laboratory study. A pattern of enhanced sexual cue responsiveness is expected in this sample if hypersexuality shares features of other addiction models. Participants (N=122) who either reported or denied problematic VSS use were presented with emotional, including explicit sexual, images while their evoked response potentials were recorded. An interaction of hypersexual problem group and the level of desire for sex with a partner predicted LPP amplitude. Specifically, those reporting problems regulating their VSS use who also reported higher sexual desire had lower LPP in response to VSS. This pattern appears different from substance addiction models. These are the first functional physiological data of persons reporting VSS regulation problems.

Sexual self-regulation and cognitive absorption as factors of sexual response toward virtual characters

The eye movements and penile responses of 20 male participants were recorded while they were immersed with virtual sexual stimuli. These participants were divided into two groups according to their capacity to focus their attention in immersion (high and low focus). In order to understand sexual self-regulation better, we subjected participants to three experimental conditions: (a) immersion with a preferred sexual stimulus, without sexual inhibition; (b) immersion with a preferred sexual stimulus, with sexual inhibition; and (c) immersion with a neutral stimulus. A significant difference was observed between the effects of each condition on erectile response and scanpath. The groups differed on self-regulation of their erectile responses and on their scanpath patterns. High focus participants had more difficulties than low focus participants with inhibiting their sexual responses and displayed less scattered eye movement trajectories over the critical areas of the virtual sexual stimuli. Results are interpreted in terms of sexual self-regulation and cognitive absorption in virtual immersion. In addition, the use of validated virtual sexual stimuli is presented as a methodological improvement over static and moving pictures, since it paves the way for the study of the role of social interaction in an ecologically valid and well-controlled way.

Erotica viewing effects on intimate relationships and self/partner evaluations

Viewing visual sexual stimuli (VSS) has been documented to have both positive (e.g., increased sexual arousal and sexual behaviors) and negative (e.g., higher anxiety, devaluing of partner attractiveness) effects. Excitation transfer and social comparison theories were used to generate hypotheses that could explain these mixed findings. Forty-four monogamous, heterosexual couples viewed erotic, exciting (non-erotic films), and nature films both alone and together. They rated their feelings of general arousal and relationship satisfaction as well as perceptions of self and partner sexual behaviors and attractiveness. Participants viewing both the erotic and exciting films reported equivalent increases in excitement; however, the erotic film was rated as slightly more generally arousing and increased participant's desire to be close to their partner. Viewing the erotic films also induced greater reports of negative affect, guilt, and anxiety. These findings moderately support a transfer of excitation interpretation. No effects of partner presence or absence while viewing the films was found. Viewing erotic films led to more positive evaluations of one's own sexual behaviors. These findings provide mixed support in regard to self and partner social comparisons. Co-occurring positive and negative emotional reactions were explored as possible explanation to the complex reactions to VSS.

Can we change sexual orientation?

The self-reports of individuals who claim that they have changed their sexual orientation are either dismissed as false or relied upon to promote sexual orientation change efforts. However, these reactions do not capture the complexity of the sexual reorientation phenomenon. This article provides an overview regarding the promise and effort of sexual reorientation and how this knowledge may inform our current understanding of human sexuality. Specifically, a brief history is given of the interventions used to change attractions to same-sex adults and the assumptions underlying these efforts. Information will be given regarding which conclusions can be derived from sexual reorientation studies. The limitations of these studies will be explained to strengthen future research. Hypotheses will be presented regarding the motivations and needs of those distressed by a same-sex erotic orientation and the impact that the hope of sexual reorientation may have for family members, religious leaders, and policy makers. A multivariate model of sexuality and sexual orientation, including scales of attraction and aversion, will be proposed based upon current understanding of sexuality and the distinctions found in sexual reorientation research. In the end, a therapeutic framework will be highlighted that may be used (and researched) to help those distressed by their sexual orientation.

Sexual arousal in men: a review and conceptual analysis

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

Assessment, diagnosis, and management of hypersexual disorders

PURPOSE OF REVIEW

This review examines recent advances in conceptualizing and treating hypersexual disorders.

RECENT FINDINGS

Studies on hypersexual disorders, inferred from research on their associated descriptors, suggest that these disorders have a strong relationship to a number of areas of functioning, in particular, self-regulation and sexually offensive behavior.

SUMMARY

The proposed inclusion of hypersexual disorders in the upcoming Diagnostic and Statistical Manual of Mental Disorders-V may address many of the current issues related to the lack of empirical research on hypersexuality. Although there have been some gains made on understanding hypersexuality, there remains a lack of consensus and empirical research on hypersexual disorders. There are also an insufficient number of controlled studies on the efficacy of pharmacological and psychological treatments for hypersexual behavior problems.

Dysregulated sexuality and high sexual desire: distinct constructs?

The literature on dysregulated sexuality, whether theoretical, clinical or empirical, has failed to differentiate the construct from high sexual desire. In this study, we tested three hypotheses which addressed this issue. A sample of 6458 men and 7938 women, some of whom had sought treatment for sexual compulsivity, addiction or impulsivity, completed an online survey comprised of various sexuality measures. Men and women who reported having sought treatment scored significantly higher on measures of dysregulated sexuality and sexual desire. For men, women, and those who had sought treatment, dysregulated sexuality was associated with increased sexual desire. Confirmatory factor analysis supported a one-factor model, indicating that, in both male and female participants, dysregulated sexuality and sexual desire variables loaded onto a single underlying factor. The results of this study suggest that dysregulated sexuality, as currently conceptualized, labelled, and measured, may simply be a marker of high sexual desire and the distress associated with managing a high degree of sexual thoughts, feelings, and needs.