Giving in to arousal or staying stuck in disgust? Disgust-based mechanisms in sex and sexual dysfunction

Self-Disgust and Sexual Functioning: A Scenario-Based Study Testing the Ability of Sex-Related Experiences to Elicit Self-Directed Disgust

Increasing evidence indicates that disgust might compromise sexual functioning and can contribute to sexual problems. Although the stimuli and conditions that elicit disgust vary greatly across individuals, they cluster in three categories of disgust elicitors: Stimuli that are associated with an increased risk of the transmission of infectious diseases (pathogen disgust), stimuli that signal poor mating quality and may jeopardize reproductive success (sexual disgust), and behaviors that violate social norms (moral disgust). It has been argued that each of these categories of disgust may interfere with sexual responses. Thus far, research on the role of disgust in sexual contexts focused on external stimuli (e.g., sperm). Yet, recently it has been proposed that disgust can also become directed to features of the self. Such self-directed disgust may also apply to sexual contexts and contribute to sexual problems. As a first step to explore the relevance of self-disgust in sexual functioning, we tested if indeed particular sexual experiences have the ability to elicit self-disgust. Using a within subject design, participants (N = 124; all women) imagined themselves as well as others experiencing a series of sex-related scenarios, each relevant for one of the three categories of disgust, and subsequently rated their self-disgust. For all types of disgust, the scenarios evoked self-disgust, and the "self-perspective" elicited significantly more self-disgust than the "other-perspective." These findings support theoretical models pointing to the relevance of taking self-disgust into consideration as a factor that may compromise sexual functioning. Future research should test whether this also holds for men.

Virtual Reality Could Help Assess Sexual Aversion Disorder

Virtual reality (VR) may improve our understanding of sexual dysfunctions' manifestations, although research in this area remains limited. This study assessed the potential use of a VR Behavior Avoidance Test (VR-BAT) as a tool for examining the clinical features of Sexual Aversion Disorder (SAD): the experience of fear, disgust, and avoidance when facing sexual cues/contexts. A sample of 55 adults (≥ 18y) with (n = 27) and without SAD (n = 28) completed a self-report measure of sexual avoidance. Their anxiety, disgust, electrodermal activity, heart rate, and visual and behavioral avoidance were then examined during two VR-BATs involving sexual or non-sexual stimuli. Mixed repeated measures ANOVAs, t-tests, and correlational analyses were performed. Results showed that individuals in the SAD group reported greater anxiety and disgust compared to their non-SAD counterparts during the sexual stimuli condition. Sexual avoidance scores were largely positively related to anxiety and disgust during the VR sexual condition, and moderately negatively related to the time spent touching the virtual character's genitals. This study is important given the prevalence of sexual difficulties, such as SAD, and the new research avenues offered by emerging technologies, like VR.

Effects of Ginger on Disgust, Sexual Arousal, and Sexual Engagement: A Placebo-Controlled Experiment

Sexual problems are common complaints across countries and cultures, and behavioral immune system theory suggests disgust plays an essential role in sexual functioning. The current study investigated 1) if disgust induced by sexual body fluids would reduce sexual arousal, reduce the likelihood of sexual engagement, and enhance disgust toward subsequent erotic stimuli, and 2) if the administration of ginger would affect these reactions. We administered either ginger or placebo pills to a sample of 247 participants (Mage = 21.59, SD = 2.52; 122 women) and asked them to complete either behavioral approach tasks with sexual body fluids or with neutral fluids. Next, participants viewed and responded to questions concerning erotic stimuli (nude and seminude pictures of opposite-sex models). As expected, the sexual body fluids tasks induced disgust. The elevated disgust induced by sexual body fluids tasks resulted in lower sexual arousal in women, whereas ginger consumption counteracted this inhibiting effect of disgust on sexual arousal. Disgust elicited by sexual body fluids also increased disgust toward the subsequent erotic stimuli. Ginger increased sexual arousal toward the erotic stimuli in both men and women who had completed the neutral fluids tasks. Findings provide further evidence of the role of disgust in sexual problems, and, importantly, that ginger may improve the sexual function of individuals via its sexual arousal-enhancing effect.

The Influence of Subjective Sexual Arousal and Disgust on Pain

Current models propose that inhibited sexual arousal is a key component in maintaining sexual pain in women with Genito-Pelvic Pain/Penetration Disorder. It thus follows that enhancing sexual arousal may be an effective strategy to modulate pain, but this effect has not been successfully demonstrated with women, although it has been successful with men. This study built on previous works and examined if the pain-killing effect of sexual arousal might have been undermined by concurrently-elicited disgust. We tested whether women experience disgust as well as sexual arousal when viewing sex stimuli, and whether disgust has an exacerbating effect on pain. Female participants (N = 164) were randomly distributed to watch a porn, disgust, or neutral train-ride film. A cold pressor test (CPT) was utilized to induce pain at the same time that participants viewed their respective film. Pain was indexed by the duration that participants kept their hand in the cold water, and by self-reported pain intensity at the time they quit the CPT. The results showed no differences in pain across conditions. The sex stimulus elicited substantial disgust as well as sexual arousal, and there was a negative correlation between the two emotions. Disgust was not found to increase pain compared to both the neutral and sex conditions. Thus, the findings provide no support for a pain-modulatory effect of subjective sexual arousal on pain in women. This might, however, be due to the sex stimulus having elicited an ambivalent state between an appetitive and aversive emotion concurrently.

Is disgust more resistant to extinction than fear? A meta-analytic review of laboratory paradigms

Disgust can be acquired via evaluative conditioning; a process by which a neutral stimulus (conditioned stimulus; CS) comes to be evaluated as disgusting due to its pairing with an inherently disgusting stimulus (unconditioned stimulus; US). Research has shown that conditioned disgust responses are resistant to extinction which may have implications for disorders (i.e., contamination-based obsessive-compulsive disorder, specific phobias, and post-traumatic stress disorder) in which heightened disgust has been implicated. Importantly, extinction is the primary mechanism by which exposure therapies are thought to achieve symptom reduction for these disorders. Exposure therapies were originally modeled on fear extinction, whereas disgust extinction was largely overlooked until recently. Accordingly, differences in the degree to which learned disgust and fear can be attenuated via extinction learning remains unclear. The present investigation was a meta-analysis directly comparing the degree of extinction of conditioned disgust (n = 14) and conditioned fear (n = 14) in laboratory paradigms. Extinction was operationalized as the standardized mean difference (SMD) in evaluative ratings between the CS+ (the CS paired with the US) and CS- (the unpaired CS) after extinction training. Results of a subgroup analysis indicated that disgust (SMD = 0.52) was significantly more resistant to extinction than fear (SMD = 0.37). Additionally, a series of meta-regression analyses indicated that extinction was not influenced by important study characteristics (e.g., sex, age, number of conditioning and extinction trials). The findings suggest that extinction-based approaches may be less effective at attenuating learned disgust and research is needed to better optimize treatments for disgust-related disorders.

Exploring Women's State-Level Anxiety in Response to Virtual Reality Erotica

Virtual Reality (VR)-based treatments for anxiety disorders are efficacious but there is a lack of research examining anxious responses to VR erotica, which could innovate treatments for sexual difficulties. We examined erotica features that elicited anxiety and sexual presence in women. Thirty-eight women viewed erotic videos from different modalities (2D, VR) and points of view (1st, 3rd person) and completed anxiety and sexual presence measures before and after each video. Women experienced greater anxiety for VR than 2D films and reported the most anxiety for VR 1st person films. Sexual presence was affected by modality and point of view.

Is Sexual Aversion a Distinct Disorder or a Trans-Diagnostic Symptom across Sexual Dysfunctions? A Latent Class Analysis

Sexual aversion disorder (SAD) is a chronic condition that impacts sexual and psychological well-being. However, the relevance of SAD as a discrete disorder remains highly debated. This study aimed to clarify the status of SAD as either a distinct disorder or a trans-diagnostic symptom shared among sexual dysfunctions. This cross-sectional study used a latent class analysis approach among a Canadian community sample (n = 1,363) to identify how patterns of SAD symptoms (i.e., sexual fear, disgust, and avoidance) emerge across different spheres of sexual functioning (i.e., desire and arousal, erection or lubrication, genito-pelvic pain, and orgasm) and examine sociodemographic and psychosexual correlates of the identified classes. Examination of fit indices suggested four classes: Sexually functional, Impaired desire and responsiveness, Sexual aversion, and Comorbid sexual dysfunctions. Sexual aversion class members were more likely to be single, had experienced sexual assault in adulthood, and report lower levels of sexual satisfaction and psychological well-being, compared to Sexually functional class members. Results suggest that SAD is a distinct clinical syndrome, while its symptoms may co-occur with other sexual dysfunctions. To ensure that the needs of people with SAD are met with tailored treatment options, future nosography might consider reclassifying SAD as a specific disorder.

Fear Learning in Genital Pain: Toward a Biopsychosocial, Ecologically Valid Research and Treatment Model

Although fear learning mechanisms are implicated in the development, maintenance, exacerbation, and reduction of genital pain, systematic research on how fear of genital pain emerges, spreads, persists, and reemerges after treatment is lacking. This paper provides an overview of the literature on pain-related fear, integrates the ideas on learning and sexual arousal responding, and specifies the pathways through which compromised learning may contribute to the development and persistence of genital pain. In order to refine theories of genital pain and optimize treatments, we need to adopt a biopsychosocial framework to pain-related fear learning and uncover potential moderators that shape individual trajectories. This involves examining the role of physiological processes, subjective experiences, as well as partner and relational cues in fear acquisition, excessive generalization and impaired safety learning, extinction of fear, counterconditioning, and return of fear. Recent methodological advances in fear conditioning and sex research are promising to enable more symptom-specific and ecologically valid experimental paradigms.

An Eye Tracking Study Examining the Role of Mating Strategies, Perceived Vulnerability to Disease, and Disgust in Attention to Pathogenic Cues

Disgust is an emotion that regulates disease avoidance and reduces the likelihood of pathogenic infections. Existing research suggests a bidirectional relationship between disgust and mating, where disgust inhibits sexual behavior and sexual behavior inhibits disgust. In the current study, we investigated the role of individual differences and mating motivations on visual attention to pathogenic cues. Participants (N = 103) were randomly assigned to a mating prime or control condition, and they were asked to view images of pathogenic cues (i.e., rotten food, exposed cuts, bodily fluids) paired with their non-pathogenic counterparts. The findings showed no effect of mating prime on visual attention to pathogenic stimuli; however, dispositional mating strategies (SOI-R) were associated with attention to pathogenic stimuli. Individuals with unrestricted sociosexual orientations viewed pathogenic stimuli longer. The findings demonstrate that dispositional mating orientation is associated with greater attention to disgusting images, a link between pathogens and mating orientation that warrants further exploration.

Bidirectional relationship between sexual arousal and (sex-related) disgust

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.

Explicitness, disgust, and safe sex behavior: A message experiment with U.S. adults

Sexual health risks are challenging to communicate given the potential negative reactions of target audiences to explicit language. Grounded in research on pathogen avoidance, the current study examined the impact of varying levels of explicit language on message perceptions and safe sex behavioral intentions. U.S. adults (N = 498) were randomly assigned to view messages detailing pandemic safe sexual behavior that contained either low or high levels of explicit language. High explicit language significantly increased perceived disgust which also indirectly linked high explicit language with increased intentions to engage in safe sex behavior. Individual difference variables moderated the impact of message explicitness; dispositional hygiene disgust moderated the impact of high explicit, hygiene-focused messages on safe sex intentions. Those with relatively low levels of dispositional disgust were more positively impacted by explicit language. The results suggest the value of increased message explicitness for sexual health communication and have implications for pathogen avoidance behaviors, the behavioral immune system, and dispositional and affective forms of disgust.

The relationship between meat disgust and meat avoidance-A chicken-and-egg problem

Feelings of disgust toward meat have been researched for at least 30 years, but so far the causal relationship that may link meat disgust and meat consumption has remained elusive. Two possible pathways have been proposed in previous literature: the more common pathway seems to be that meat disgust is developed after a transition to vegetarianism, potentially via the process of moralization and recruitment of (moral) disgust. Other accounts suggest the existence of a second pathway in which disgust initiates the avoidance of meat and this can be explained by existing theories of disgust functioning as a pathogen avoidance mechanism and meat serving as a pathogen cue. However, the evidence base for either relationship remains thin and to our knowledge no research has examined whether temporary meat abstention can lead to increases in meat disgust, as the first pathway suggests. We measured meat disgust and meat intake in n = 40 meat eaters before and after attempting a meat-free diet for 1 month (while taking part in the annual vegan campaign Veganuary). Although most participants lapsed to eating meat during this period, we found that reductions in meat intake during the month were predictive of increases in meat disgust afterwards. This supports the view that meat disgust is expressed as a result of meat avoidance in meat eaters. Implications for theoretical understanding of the relationship between meat disgust and meat avoidance, as well as the development of disgust based interventions are discussed.

Age-related differences in self-reported disgust toward core disgust, sex-related, and food stimuli

INTRODUCTION

While disgust is functional in preventing contagion from pathogens, it also plays a role in various psychopathologies. Disgust responses toward dirt, bodily secretions, certain types of food, and sexual stimuli typically emerge during (early) childhood. However, there is a lack of research on how disgust develops. This cross-sectional study investigated whether there are age-related differences in subjective, self-reported disgust between early and late adolescence and whether there are differences for distinctive types of disgust (core-disgust, sex-related, food-related).

METHODS

Using an online survey, 240 Dutch children (116 female, 124 male) aged 9 through 16 years rated the extent to which they found the different types of stimuli disgusting or not on a VAS scale.

RESULTS AND CONCLUSIONS

The results showed that only the disgust responses to sex-related stimuli decreased with age, whereas disgust toward the other categories did not show any age-related differences. Overall girls reported somewhat higher disgust ratings than boys for sex-related stimuli, but not for the other categories. The present study offers important new angles for future research, which might further disentangle the mechanisms through which the changes occur.

Sex Drive as a Possible Mediator of the Gender Difference in the Prevalence of Paraphilic Interests in a Nonclinical Sample

There is a general gender difference in paraphilic interests, such that men report more interest (and greater engagement) in a variety of paraphilic behaviors. Using a nonclinical sample, Dawson et al. (Sexual Abuse, 28(1):20-45, 2016, https://doi.org/10.1177/1079063214525645 ) found that the gender difference in paraphilic interests was eliminated when scores on measures of sex drive were used as mediators. However, their measures of sex drive were about more than just sex drive and included a measure of hypersexuality (i.e., distress, perceived lack of control, and problematic consequences of one's sexuality). This study had two aims: to replicate Dawson et al.'s mediation results (using the same measures and scoring methods), and to discern the effect of sex drive itself (by replacing their measure of hypersexuality with a measure of sex drive). A nonclinical sample of 517 men and 615 women completed an online questionnaire. As expected, men reported less repulsion than women for most paraphilic themes. The gender difference in paraphilic interests was reduced (but not eliminated) both when reproducing Dawson et al.'s analysis and when examining a mediation model focused on sex drive specifically. The same results were obtained when examining the paraphilic interest with the largest gender difference (i.e., voyeurism). A full mediation effect was obtained in an unplanned supplementary analysis using a factor score (derived from eight measures) putatively assessing sex drive. While the main findings are consistent with Dawson et al.'s conclusions that sex drive is a possible mediator, they also suggest that other factors need to be considered to help explain the gender difference in the prevalence of paraphilic interests.

Beyond vernacular: Measurement solutions to the lexical fallacy in disgust research

Disgust may play an important role in several mental disorders, in part because disgust seems impervious to corrective information, a feature noted long before it was studied by clinical psychologists. A deeper understanding of disgust could improve not only the treatment of mental disorders, but also other societal problems involving this peculiar emotion. In this paper, we review the measurement of disgust and identify issues that hold back progress in understanding how to treat this emotion. First, self-report measures of disgust, although optimized in terms of reliability, are compromised in terms of validity due to the "lexical fallacy," that is, the assumption that vernacular usage of emotion terms reveals natural kinds. Improved self-report measures that parse disgust from neighboring states of discomfort and disapproval can address this limitation, but these approaches are absent in clinical psychology. Second, "objective" measures of disgust, although free of vernacular limitations, require greater psychometric scrutiny. In a critical review, we find that most instrument-based measures fail to demonstrate adequate reliability, rendering them unsuitable for the individual differences research crucial to clinical psychology. In light of this assessment, we provide several recommendations for improving the reliability and validity of disgust measurement, including renewed attention to theory.

Newlywed Couples' Own and Partner Sexual Disgust Sensitivities Interact to Predict Their Marital Satisfaction Through Their Sexual Satisfaction

Sex is integral to maintaining a satisfying long-term romantic relationship such as marriage. It is thus important to identify the factors that promote sexual satisfaction in these relationships. To this end, we examined the extent to which a crucial evolved individual difference-sexual disgust sensitivity-impacts people's sexual satisfaction and relationship satisfaction. Using a two-year longitudinal study of 102 newlywed couples (204 individuals), we demonstrated that, rather than exerting main effects, the interaction of both couple members' sexual disgust sensitivities was indirectly associated with marital satisfaction through sexual satisfaction. People whose partners' sexual disgust sensitivities were relatively similar (versus dissimilar) to their own maintained higher levels of sexual satisfaction across the first two years of marriage, which was associated with similarly elevated marital satisfaction. Not only do these findings highlight the importance of integrating evolutionary perspectives and relationship science, they underscore the value of conducting dyadic research to examine the unique intersection of both couple members' characteristics for people's relationship outcomes.

Up-regulating Sexual Arousal and Down-regulating Disgust while Watching Pornography: Effects on Sexual Arousal and Disgust

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; µ_age = 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.

The Prevalence of Paraphilic Interests in the Czech Population: Preference, Arousal, the Use of Pornography, Fantasy, and Behavior

The number of population-based studies focused on the prevalence of paraphilic sexual interests in men is very low and for women, the subject remains largely unexplored. The two main aims of this study are to investigate the prevalence of paraphilias and to explore sex differences in an online representative sample of Czech men and women using various dimensions of sexual experience. We collected data about sexual motivations and behavior from a representative online sample of 10,044 Czechs (5,023 men and 5,021 women). In a standardized online interview, participants answered questions about selected dimensions of sexual experience within specific paraphilic patterns: sexual preferences, sexual arousal, sexual fantasies in the past 6 months, pornography use in the past 6 months, and experience with paraphilic behaviors. Our results show that 31.3% of men (n = 1,571) and 13.6% of women (n = 683) admitted to at least one paraphilic preference. Moreover, 15.5% of men and 5% of women reported more than one paraphilic preference. Except for beating/torture and humiliation/submission, in terms of real experience with such behaviors almost all paraphilias were more common among men than among women. Our results indicate that the high prevalence of some paraphilic patterns might render their pathologization problematic.

Watching Disgustedly? Game of Thrones and Disgust Sensitivity

The HBO show Game of Thrones is fascinating, because despite many of its plot points involving the elicitation of disgust, an emotion associated with avoidance behaviors, its viewership has only surged. We explore the relationship between disgust sensitivity and perception of scenes involving moral, sexual, and pathogen disgust in the show by providing participants with descriptions of such scenes. Participants included those who had never seen the show, those who had seen the show at least once, and those who had seen the show multiple times. We found that those who had watched the show once rated the scenes as less disgusting (overall and for moral and sexual disgust) than those who had not. We also investigated sex differences in disgust and found that women rated the scenes as more aversive than men, especially those involving moral and sexual disgust. Finally, those with more opposite sex siblings were more repulsed by the scenes, especially those involving sexual disgust. The present study adds to a long list of studies that analyses popular culture from an adaptive lens and adds to the notion that popular culture is a 'cultural remain' of the evolved human mind.

The effect of differential disgust conditioning and subsequent extinction versus counterconditioning procedures on women's sexual responses to erotic stimuli

Recent theoretical accounts point to disgust as an important factor in the development and persistence of sexual dysfunctions. This study tested if (i) contingent disgust experiences can render initially sexually arousing stimuli disgusting, and (ii) such acquired disgust responses could be best neutralized via a CS-only extinction or a counterconditioning procedure. Participants (N = 74) were exposed to a differential conditioning procedure that was followed by either a CS-only extinction or a counterconditioning procedure. Erotic films served as the CS+/CS-. A disgusting film served as the US. During the extinction procedure, the CS+ was no longer followed by the disgusting US. During counterconditioning the CS+ was paired with positive stimuli. After conditioning, the CS + elicited lower genital arousal and was rated as significantly more disgusting, less pleasant, and less sexually arousing than the CS-. These diminished genital and subjective sexual arousal responses to the CS+ were successfully restored after both the extinction and the counterconditioning procedure, whereas conditioned feelings of disgust and behavioral avoidance persisted. There was no evidence for differential effectiveness of either procedure. Thus, sexual responses can be attenuated by learned sex-disgust associations and restored by extinction and counterconditioning procedures, but conditioned feelings of disgust seem more resistant.

Exploring the Role of Sexual Avoidance in Male Sexual Dysfunction

Theoretical models of male sexual dysfunction highlight the role of sexual avoidance as a maintaining factor. However, little empirical research has directly tested the role of sexual avoidance in samples of men with sexual problems. The goals of the current study were to A) assess the association between sexual avoidance, sexual function, and subjective sexual well-being, and B) explore possible predictors of sexual avoidance, including insecure attachment, activation of negative sexual schemas, and trait experiential avoidance. One hundred and fifty eight men with self-identified impairments in sexual function (low desire, erectile function, and/or premature/delayed ejaculation) completed validated self-report measures in a secure online survey. Sexual avoidance was uniquely predicted by most aspects of sexual function, and was correlated with poorer subjective sexual well-being. Higher levels of attachment avoidance and activation of negative schemas uniquely predicted more frequent sexual avoidance. Alternatively, interaction models suggested that impaired erectile function was less likely to be associated with sexual avoidance for those with high levels of attachment anxiety and for those with high levels of trait experiential avoidance. Theoretical and practical implications are discussed.

The Reciprocal Relationship Between Sexual Arousal and Disgust as Evidenced in Automatic Approach-Avoidance Behavior

Sexual encounters imply exposure to stimuli that in other contexts typically elicit disgust-induced avoidance. To explain why people nevertheless tend to show sexual approach, it has been proposed that heightened sexual arousal may temporarily inhibit disgust. In line with this, studies have found that sexually aroused individuals showed heightened willingness to approach disgusting stimuli. Because automatic processes are critically involved in sexual behaviors, we examined whether the impact of sexual arousal extends to automatic responses to disgust-elicitors. To test the proposed reciprocal relationship between sex and disgust, we also investigated whether disgust reduces automatic sexual approach. In Study 1, 116 female participants (M = age 19.53) were assigned to a sexual arousal or control condition and performed a speeded approach-avoidance task to assess automatic responses to disgusting stimuli. In Study 2, 174 female participants (M = age 22.14) were assigned to a disgust, sexual arousal, or control condition and performed an approach-avoidance task involving both sex and disgust-relevant stimuli. Sexual arousal did not affect automatic responses to disgusting stimuli, and disgust did not influence automatic responses towards sexual stimuli. The reciprocal relationship between sexual arousal and disgust that was previously found for controllable responses did not extend to automatic responses.

Is "Dilator Use" More Effective Than "Finger Use" in Exposure Therapy in Vaginismus Treatment?

Vaginismus is the persistence of difficulties in allowing the vaginal entry of a penis, a finger or a gynecologic examination. This study aimed to compare the success rates of vaginismus therapy with exposure therapy treatment using a finger or a dilator. The finger training group (FTG) (n = 30) and the dilator training group (DTG) (n = 30) were established. Groups were trained about dilatation and desensitization. The Female Sexual Function Index (FSFI) was applied. From the baseline measurement to the post-treatment measurement, the average change in FSFI scores for both groups was statistically significant (p < 0.001). There was a significant difference between two groups in terms of patient drop-out numbers (p = 0.016); the DTG was more successful in continuing treatment than the FTG. This research revealed that DTG is more successful in treatment continuity and show more improvement in sexual functions.

Interactions between inflammation and female sexual desire and arousal function

PURPOSE OF REVIEW

To describe the current state of research on interactions between inflammation and female sexual function.

RECENT FINDINGS

Inflammation may interfere with female sexual desire and arousal via direct (neural) and indirect (endocrine, vascular, social/behavioral) pathways. There are significant sex differences in the effect of inflammation on sexual function, arising from different evolutionary selection pressures on regulation of reproduction. A variety of inflammation-related conditions are associated with risk of female sexual dysfunction, including cardiovascular disease, metabolic syndrome, and chronic pain.

SUMMARY

Clinical implications include the need for routine assessment for sexual dysfunction in patients with inflammation-related conditions, the potential for anti-inflammatory diets to improve sexual desire and arousal function, and consideration of chronic inflammation as moderator of sexual effects of hormonal treatments. Although the evidence points to a role for inflammation in the development and maintenance of female sexual dysfunction, the precise nature of these associations remains unclear.

Virtual Reality and Sex Therapy: Future Directions for Clinical Research

Rapidly growing new technologies are revolutionizing the field of mental health, in terms of both understanding and treating mental disorders. Among these, virtual reality (VR) is a powerful tool providing clients with new learning experiences benefiting their psychological well-being. This article offers an overview of the current literature on VR in psychotherapy, highlighting its relevance to sexual dysfunction (SD) treatment.A literature review of PubMed and Google Scholar databases was used to provide a description of the theoretical frameworks and clinical indications associated with VR use in psychotherapy and SD treatment. The effectiveness of VR exposure-based therapy has been empirically validated for several mental disorders, notably anxiety disorders. The emerging combined use of VR and mindfulness tends to focus on chronic pain treatment. Experimental research examining the use of immersive technologies in the treatment of SDs is lacking.Given the shortcomings of conventional SD treatments, exploring and developing specialized VR interventions may prove beneficial. VR offers promising avenues in sex therapy, particularly for the treatment of genital pain disorders or SDs in which anxiety plays a significant etiological role.

Visual Attention to Sexual Stimuli in Mostly Heterosexuals

Individuals who report mostly heterosexual orientations (i.e., mostly sexually attracted to the opposite sex, but occasionally attracted to the same sex) outnumber all other non-heterosexual individuals combined. The present study examined whether mostly heterosexual men and women view same- and other-sex sexual stimuli differently than exclusively heterosexual men and women. A novel eye-tracking paradigm was used with 162 mostly and exclusively heterosexual men and women. Compared to exclusively heterosexual men, mostly heterosexual men demonstrated greater attention to sexually explicit features (i.e., genital regions and genital contact regions) of solo male and male-male erotic stimuli, while demonstrating equivalent attention to sexually explicit features of solo female and female-female erotic stimuli. Mediation analyses suggested that differences between mostly and exclusively heterosexual profiles in men could be explained by mostly heterosexual men's increased sexual attraction to solo male erotica, and their increased sexual attraction and reduced disgust to the male-male erotica. No comparable differences in attention were observed between mostly and exclusively heterosexual women-although mostly heterosexual women did demonstrate greater fixation on visual erotica overall-a pattern of response that was found to be mediated by reduced disgust.

A Proximal Perspective on Disgust

The functional basis of disgust in disease avoidance is widely accepted; however, there is disagreement over what disgust is. This is a significant problem, as basic questions about disgust require knowing if single/multiple forms/processes exist. We address this issue with a new model with one form of disgust generated by multiple processes: (a) pure disgust experienced during gastrointestinal illness; (b) somatosensory disgust elicited by specific cues that activate the pure disgust state; (c) anticipatory disgust elicited by associations between distance cues for somatosensory disgust and requiring threat evaluation; (d) simulated disgusts elicited by imagining somatosensory and anticipatory disgust and frequently involving other emotions. Different contamination processes interlink (a–d). The implications of our model for fundamental questions about disgust (e.g., emotion status; continuation into animals) are examined.

[Obstetric outcome of women with primary vaginismus]

Introduction

Dysfonction importante, le vaginisme est un problème tant individuel que du couple qui peut altérer la relation sexuelle. Il peut influencer le pronostic obstétrical. Le but de cette étude était de déterminer si les caractéristiques cliniques du vaginisme ont une incidence sur le processus de l’accouchement.

Méthodes

Etude rétrospective multicentrique incluant des patientes affectées par un vaginisme primaire, ayant donné naissance à terme à un premier enfant vivant, entre 2005 et 2015.

Résultats

Sur les 19 patientes inclues dans l’étude, nous avons constaté 9 grossesses prolongées, 14 mises en travail spontanées (dont 8 à terme atteint), 3 césariennes en dehors du travail et 2 déclenchements artificiels. Parmi les 16 femmes ayant eu un travail, nous avons dénombré 4 césariennes, 5 accouchements par voie basse avec forceps et 7 par voie basse spontanée. Parmi les 12 accouchements par voie basse, 9 épisiotomies ont été pratiquées, 7 femmes ont présenté des déchirures périnéales spontanées seules ou associées à une épisiotomie, aucune lésion périnéale de type 3 ou 4, ni de périnées intacts n’ont été recensés. Le poids moyen des nouveau-nés était de 3380g±332 (2870g-3970g, 47^e percentile).

Conclusion

La proportion d’accouchements dystociques et la morbidité périnéale étaient notablement élevées, ce qui parait comparable avec la plupart des données de la littérature. Il est possible que les composantes psychologiques et comportementales du vaginisme, (mécanisme de peur-évitement, anxiété) aient favorisé les grossesses prolongées, les césariennes, les dystocies mécaniques et les lésions périnéales. Des études complémentaires sont nécessaires afin de mieux cerner le vaginisme et ses implications obstétricales.

The influence of olfactory disgust on (Genital) sexual arousal in men

Background

The generation or persistence of sexual arousal may be compromised when inhibitory processes such as negative emotions, outweigh sexual excitation. Disgust particularly, has been proposed as one of the emotions that may counteract sexual arousal. In support of this view, previous research has shown that disgust priming can reduce subsequent sexual arousal. As a crucial next step, this experimental study tested whether disgust (by means of odor) can also diminish sexual arousal in individuals who are already in a state of heightened sexual excitation.

Methodology

In this study, participants were all men (N = 78). To elicit sexual arousal, participants watched a pornographic video. Following 4.30 minutes from the start of the video clip, they were exposed to either a highly aversive/disgusting odor (n = 42), or an odorless diluent/solvent (n = 36), that was delivered via an olfactometer, while the pornographic video continued. In both conditions the presentation of the odor lasted 1 second and was repeated 11 times with intervals of 26 seconds. Sexual arousal was indexed by both self-reports and penile circumference.

Principal findings

The disgusting odor (released when the participants were already sexually aroused) resulted in a significant decrease of both subjective and genital sexual arousal compared to the control (odorless) condition.

Significance

The finding that the inhibitory effect of disgust was not only expressed in self-report but also expressed on the penile response further strengthens the idea that disgust might hamper behavioral actions motivated by sexual arousal (e.g., poor judgment, coercive sexual behavior). Thus, the current findings indicate that exposure to an aversive odor is sufficiently potent to reduce already present (subjective and) genital sexual arousal. This finding may also have practical relevance for disgust to be used as a tool for self-defence (e.g., Invi Bracelet).

The Role of Disgust in Male Sexual Decision-Making

Sexual arousal is known to increase risky behaviors, such as having unprotected sex. This may in part relate to the emotion of disgust, which normally serves a disease avoidant function, and is suppressed by sexual arousal. In this report we examine disgust's role in sexual decision-making. Male participants received two study packets that were to be completed at home across two different time-points. Participants were asked to complete one packet in a sexually aroused state and the other in a non-aroused state. Participants were asked to rate: (1) arousal, (2) disgust, (3) willingness for sex, and (4) disease risk toward a range of female targets, which varied in level of potential disease risk (sex-worker vs. non sex-worker) and attractiveness. A measure of trait disgust was also included along with other related scales. Sexual arousal was associated with reduced disgust and reduced judgments of disease risk for all targets—these latter two variables being correlated—and with enhanced willingness to have sex with all of the depicted persons. Willingness to have sex when aroused (in contrast to non-aroused) was predicted by disease risk judgments and trait disgust, suggesting both direct (state) and indirect (trait) effects of disgust on sexual decision-making.

Disgust Toward Sex-Relevant and Sex-Irrelevant Stimuli in Pre-, Early, and Middle Adolescence

For prepubertal youth, sexual stimuli elicit disgust and avoidance, yet in adolescence this avoidance shifts to sexual approach. One explanation could be that disgust declines in adolescence. This project examined whether disgust is indeed lower in adolescence compared to preadolescence, and whether this difference across age groups would be restricted to sex-relevant disgust elicitors. We also examined whether the strength of disgust would depend on familiarity between participant and source. To examine disgust responses in youths, two cross-sectional studies (N = 248, ages six to 17 years) were conducted using scenario-based measurements. Disgust was overall higher in early adolescence than in preadolescence and relatively weak when the source of disgust was a familiar person. Specifically, when parents were the source, sex-relevant disgust was higher in the groups of early and middle adolescents than in the group of preadolescents. Sex-relevant disgust elicited by a stranger or best friend, however, was lower in middle than in early adolescence. The latter is consistent with the view that repeated confrontation with disgusting stimuli might attenuate disgust, which could contribute to healthy sexual functioning. The heightened sex-relevant disgust in middle adolescents when parents were the source might reflect a functional avoidance mechanism of inappropriate sex mates.

Sexuality in autism: hypersexual and paraphilic behavior in women and men with high-functioning autism spectrum disorder

Like nonaffected adults, individuals with autism spectrum disorders (ASDs) show the entire range of sexual behaviors. However, due to the core symptoms of the disorder spectrum, including deficits in social skills, sensory hypo- and hypersensitivities, and repetitive behaviors, some ASD individuals might develop quantitatively above-average or nonnormative sexual behaviors and interests. After reviewing the relevant literature on sexuality in high-functioning ASD individuals, we present novel findings on the frequency of normal sexual behaviors and those about the assessment of hypersexual and paraphilic fantasies and behaviors in ASD individuals from our own study. Individuals with ASD seem to have more hypersexual and paraphilic fantasies and behaviors than general-population studies suggest. However, this inconsistency is mainly driven by the observations for male participants with ASD. This could be due to the fact that women with ASD are usually more socially adapted and show less ASD symptomatology. The peculiarities in sexual behaviors in ASD patients should be considered both for sexual education and in therapeutic approaches.

Cognitive mechanisms of disgust in the development and maintenance of psychopathology: A qualitative review and synthesis

A growing body of research has implicated disgust in various psychopathologies, especially anxiety-related disorders. Although the observed role of disgust in many disorders is robust, the mechanisms that may explain this role are unclear. Cutting-edge research in cognitive science has the potential to elucidate such mechanisms and consequently improve our understanding of how disgust contributes to the etiology and maintenance of psychopathology. In this qualitative review, we systematically assess cognitive bias mechanisms that have been linked to disgust and its disorders. This review suggests that disgust-related biases may be observed in memory, interpretation, judgment of expectancies, and attention, as well as at implicit levels. Of these cognitive domains, the most robust bias appears to be observed at the level of attention. However, reliable moderators of attentional biases for disgust have not yet been identified, and this bias has not been systematically linked to other levels of analysis. Despite these limitations, the available research indicates that attentional avoidance rather than orienting or maintenance may be the most characteristic of disgust. Attentional avoidance of disgust may have important implications for etiological and treatment models of disorders characterized by excessive disgust reactions. The implications for advancing such models are discussed in the context of a combined cognitive bias hypothesis.

Affective and Autonomic Responses to Erotic Images: Evidence of Disgust-Based Mechanisms in Female Sexual Interest/Arousal Disorder

Disgust has recently been implicated in the development and maintenance of female sexual dysfunction, yet most empirical studies have been conducted with a sexually healthy sample. The current study contributes to the literature by expanding the application of a disgust model of sexual functioning to a clinically relevant sample of women with low sexual desire/arousal and accompanying sexual distress. Young women (mean age = 19.12 years) with psychometrically defined sexual dysfunction (i.e., female sexual interest/arousal disorder [FSIAD] group) and a healthy control group were compared in their affective (i.e., facial electromyography [EMG] and self-report) and autonomic (i.e., heart rate and electrodermal activity) responses to disgusting, erotic, positive, and neutral images. Significant differences were predicted in responses to erotic images only. Specifically, it was hypothesized that the FSIAD group would display affective and autonomic responses consistent with a disgust response, while responses from the control group would align with a general appetitive response. Results largely supported study hypotheses. The FSIAD group displayed significantly greater negative facial affect, reported more subjective disgust, and recorded greater heart rate deceleration than the control group in response to erotic stimuli. Greater subjective disgust response corresponded with more sexual avoidance behavior. Planned follow-up analyses explored correlates of subjective disgust responses.

The rise of moral emotions in neuropsychiatry

Clinical psychopathology has largely ignored the developments in the field of social neuroscience. The so-called moral emotions are a group of affective experiences thought to promote cooperation, group cohesion, and reorganization. In this review, we: (i) briefly describe a provisional taxonomy of a limited set of moral emotions and their neural underpinnings; and (ii) discuss how disgust, guilt, anger/indignation, and shame/embarrassment can be conceptualized as key affective experiences in different neuropsychiatric disorders. Based on a concise review of the literature linking moral emotions, psychopathology, and neuropsychiatry, we have devised a simple and preliminary scheme where we conjecture how specific moral emotions can be implicated in some categories of DSM-5 diagnoses, potentially helping to bridge psychopathology and neurobiologically plausible variables, in line with the Research Domain Criteria initiative. We hope this stimulates new empirical work exploring how moral emotional changes and their underlying neurobiology can help elucidating the neural underpinnings of mental disorders.

Paraphilic Interests: An Examination of Sex Differences in a Nonclinical Sample

Little research has been conducted to examine paraphilic sexual interests in nonclinical samples. The little that exists suggests that atypical sexual interests are more common in men than in women, but the reasons for this difference are unknown. In this study, we explored the prevalence of paraphilic interests in a nonclinical sample of men and women. We expected that men would report greater arousal (or less repulsion) toward various paraphilic acts than women. We also examined putative correlates of paraphilias in an attempt to explain the sex difference. In all, 305 men and 710 women completed an online survey assessing sexual experiences, sexual interests, as well as indicators of neurodevelopmental stress, sex drive, mating effort, impulsivity, masculinity/femininity, and socially desirable responding. As expected, significant sex differences were found, with men reporting significantly less repulsion (or more arousal) to the majority of paraphilic acts than women. Using mediation analysis, sex drive was the only correlate to significantly and fully mediate the sex difference in paraphilic interests. In other words, sex drive fully accounted for the sex difference in paraphilic interests. The implications of these findings for understanding the etiology of atypical sexual interests are discussed.