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Marques JM, Figueiredo CPM, Scanavino MDT. A review of published studies on virtual reality in sexuality research. Sex Med Rev 2024; 12:371-386. [PMID: 38705842 DOI: 10.1093/sxmrev/qeae024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/14/2024] [Accepted: 03/29/2024] [Indexed: 05/07/2024]
Abstract
INTRODUCTION Virtual reality (VR) technology contributes to greater approach of methodological safety to make ecological validity more feasible and a growing interest in sexuality behaviors. OBJECTIVES The aim of this study was to show VR in the sexuality area by a comprehensive review of outcomes, offer a synthesis of the studies, and make a methodological quality assessment of finding results. A secondary goal was to investigate the effect of immersion on diverse sexual responses outcomes. METHODS We designed a review based on a systematic review strategy describing types of studies, participants, data collection and outcomes; searched in 4 electronic databases (PubMed, EMBASE, PsycINFO, and SciELO), and made a full-text screening process. RESULTS The study found 18 articles that met research criteria synthesized within 3 outcome groups: erection measures, level of immersion, and biomarker studies. Synthesis shows a lack of methodological aspects that impair results, such as description of methods from bias protection, randomization, or concealment. The literature still needs to improve its methodology, even though it already shows relevant data for intervention in sexual dysfunction, forensic psychiatry, sexual attraction, orientation, and use of pornography. CONCLUSION Current methodological issues need better design to highlight relevant issues in sexuality with stronger quality of design, opening boundaries to new diagnostic or interventional technologies to sexual health.
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Affiliation(s)
- João Miguel Marques
- Excessive Sexual Drive and Prevention of Negative Outcome Associated to Sexual Behavior Outpatient Unit, Institute of Psyquiatry (IPq) Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Caio Petrus Monteiro Figueiredo
- Institute of Psyquiatry (IPq) Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Marco D T Scanavino
- Excessive Sexual Drive and Prevention of Negative Outcome Associated to Sexual Behavior Outpatient Unit, Institute of Psyquiatry (IPq) Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Experimental Pathophysiology Post Graduation Program, Institute of Psyquiatry (IPq) Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
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Katz MA, Penniston TL, Barry C, Micanovic N, Seto MC, Chivers ML. Use of sexual stimuli in research and clinical settings: expert opinion and recommendations. Sex Med 2023; 11:qfad012. [PMID: 37256214 PMCID: PMC10225467 DOI: 10.1093/sexmed/qfad012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 03/01/2023] [Accepted: 03/05/2023] [Indexed: 06/01/2023] Open
Abstract
Background Sexual stimuli, such as sexual videos, images, and narratives describing sexual interactions, are one of many tools used by clinicians and researchers to elicit or augment sexual response. Given the wide variability within sexual stimuli and their effects on sexual response, we provide guidance on when and how to use sexual stimuli, selecting sexual stimuli, and standardizing the use and reporting of sexual stimuli in research and clinical practice. Aim This expert opinion review article discusses standard operating procedures when using sexual stimuli in clinical and research applications, addressing 3 broad areas: settings in which sexual stimuli are used, characteristics and contexts of the stimuli, and practical and ethical considerations when using the stimuli. Methods This article is based on an expert opinion review of the sexual psychophysiology literature. Results First, we discuss the settings in which sexual stimuli are typically used and evaluate the ecological validity of each setting. Second, we review the types of sexual stimuli used in sexual response research, including physical characteristics, depicted sexual activity, and context, and the impacts of these characteristics on sexual response. Last, we discuss the practical and ethical considerations that come with the choice and use of sexual stimuli in clinical and research settings. We address potential limitations of certain sexual stimuli, including practical and ethical considerations such as participant vs experimenter choice, diversity and representation, and proper sourcing of sexual stimuli for use in clinical and research applications. Discussions on the future applications of sexual stimuli, such as the use of virtual reality, and ethical considerations in terms of user-generated Internet sexual stimuli are also explored. Conclusion We provide an expert opinion review of the literature regarding use of sexual stimuli for clinical and research applications and offer best use practices and recommendations.
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Affiliation(s)
- Maddie A Katz
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, N2L 3C5, Canada
| | - Trinda L Penniston
- Department of Psychology, Queen’s University, Kingston, Ontario, K7L 3N6, Canada
| | - Caitlin Barry
- Department of Psychology, Queen’s University, Kingston, Ontario, K7L 3N6, Canada
| | - Nina Micanovic
- Department of Psychology, Queen’s University, Kingston, Ontario, K7L 3N6, Canada
| | - Michael C Seto
- Royal Ottawa Health Care Group, Brockville Mental Health Centre, Ottawa, Ontario, K1Z 7K4, Canada
- Department of Psychiatry, University of Ottawa, Kingston, Ottawa, Ontario, K1N 6N5, Canada
| | - Meredith L Chivers
- Corresponding author: Department of Psychology, 62 Arch Street Humphrey Hall, Room 232, Queen’s University, Kingston, ON, K7L 3N6, Canada.
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Milani S, Dawson SJ, Velten J. Visual Attention and Sexual Function in Women. CURRENT SEXUAL HEALTH REPORTS 2021. [DOI: 10.1007/s11930-021-00312-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Abstract
Purpose of Review
Theoretical models situate attention as integral to the onset and regulation of sexual response and propose that problems with sexual response and subsequent sexual dysfunction result from insufficient attentional processing of sexual stimuli. The goal of this paper is to review literature examining the link between attentional processing of sexual stimuli and sexual function in women. Specifically, we sought to understand whether women with and without sexual dysfunction differ in their visual attention to sexual stimuli and examined the link with sexual response, which would support attention as a mechanism underlying sexual dysfunction.
Recent Findings
Across women with and without sexual concerns, sexual stimuli are preferentially attended to relative to nonsexual stimuli, suggesting that sexual stimuli are more salient than nonsexual stimuli. Differences between women with and without sexual dysfunction emerge when examining visual attention toward the most salient features of sexual stimuli (e.g., genital regions depicting sexual activity). Consistent with theoretical models, visual attention and sexual response are related, such that increasing attention to sexual cues facilitates sexual arousal, whereas reduced attention to sexual stimuli appears to suppress sexual arousal, which may contribute to sexual difficulties in women.
Summary
Taken together, the research supports the role of visual attention in sexual response and sexual function. These findings provide empirical support for interventions that target attentional processing of sexual stimuli. Future research is required to further delineate the specific attentional mechanisms involved in sexual response and investigate whether these are modifiable. This knowledge may be beneficial for developing novel psychological interventions targeting attentional processes in the treatment of sexual dysfunctions.
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Velten J, Milani S, Margraf J, Brotto LA. Visual attention and sexual arousal in women with and without sexual dysfunction. Behav Res Ther 2021; 144:103915. [PMID: 34174705 DOI: 10.1016/j.brat.2021.103915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 05/01/2021] [Accepted: 06/09/2021] [Indexed: 11/25/2022]
Abstract
Attention to sexual stimuli is a prerequisite to process such stimuli as sexually-meaningful and is an important means to facilitate sexual arousal. Attending to sexual cues is crucial for healthy sexual functioning. Studies suggest that sexual dysfunction is associated with less attention towards sexual stimuli. The goal of this study was to use an eye-tracking-based free-viewing paradigm to investigate whether women with sexual dysfunction visually attend to the genital area in dynamic sexual stimuli (i.e., erotic videos) differently than women with subclinical sexual function or those with typical sexual functioning. A total of 69 women (Mage = 27.77, SD = 8.00) with clinical (n = 30), subclinical (n = 23), and typical (n = 16) levels of sexual functioning watched four 1-min video clips depicting heterosexual couples engaging in vaginal intercourse or cunnilingus while the total fixation duration on the genital area as well as their subjective and genital sexual arousal were recorded. As hypothesized, the clinical group fixated on the genital area less than women with typical sexual functioning. A longer total fixation duration on the genital area was followed by increases in subjective arousal and genital arousal. The relationship between attention and arousal was not moderated by sexual functioning group. This study provides first evidence of the role of sustained visual attention for facilitating sexual arousal in women with and without sexual dysfunction.
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Affiliation(s)
- Julia Velten
- Mental Health Research and Treatment Center, Department of Clinical Psychology and Psychotherapy, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany.
| | - Sonia Milani
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada.
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Department of Clinical Psychology and Psychotherapy, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany.
| | - Lori A Brotto
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada.
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Dickenson JA, Diamond L, King JB, Jenson K, Anderson JS. Understanding heterosexual women's erotic flexibility: the role of attention in sexual evaluations and neural responses to sexual stimuli. Soc Cogn Affect Neurosci 2021; 15:447-465. [PMID: 32415978 PMCID: PMC7308660 DOI: 10.1093/scan/nsaa058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 02/10/2020] [Accepted: 04/13/2020] [Indexed: 11/13/2022] Open
Abstract
Many women experience desires, arousal and behavior that run counter to their sexual orientation (orientation inconsistent, 'OI'). Are such OI sexual experiences cognitively and neurobiologically distinct from those that are consistent with one's sexual orientation (orientation consistent, 'OC')? To address this question, we employed a mindful attention intervention-aimed at reducing judgment and enhancing somatosensory attention-to examine the underlying attentional and neurobiological processes of OC and OI sexual stimuli among predominantly heterosexual women. Women exhibited greater neural activity in response to OC, compared to OI, sexual stimuli in regions associated with implicit visual processing, volitional appraisal and attention. In contrast, women exhibited greater neural activity to OI, relative to OC, sexual stimuli in regions associated with complex visual processing and attentional shifting. Mindfully attending to OC sexual stimuli reduced distraction, amplified women's evaluations of OC stimuli as sexually arousing and deactivated the superior cerebellum. In contrast, mindfully attending to OI sexual stimuli amplified distraction, decreased women's evaluations of OI stimuli as sexually arousing and augmented parietal and temporo-occipital activity. Results of the current study constrain hypotheses of female erotic flexibility, suggesting that sexual orientation may be maintained by differences in attentional processing that cannot be voluntarily altered.
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Affiliation(s)
- Janna A Dickenson
- Human Sexuality, California Institute of Integral Studies, San Francisco, CA 94103, USA.,Department of Psychology, University of Utah, Salt Lake City, UT 84112, USA
| | - Lisa Diamond
- Department of Psychology, University of Utah, Salt Lake City, UT 84112, USA
| | - Jace B King
- Department of Radiology and Imaging Sciences, School of Medicine, University of Utah, Salt Lake City, UT 84132, USA.,Program in Neuroscience, University of Utah, Salt Lake City, UT 84108, USA
| | - Kay Jenson
- Department of Psychology, University of Utah, Salt Lake City, UT 84112, USA
| | - Jeffrey S Anderson
- Department of Radiology and Imaging Sciences, School of Medicine, University of Utah, Salt Lake City, UT 84132, USA.,Program in Neuroscience, University of Utah, Salt Lake City, UT 84108, USA.,Department of Bioengineering, University of Utah, Salt Lake City, UT 84108, USA
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van Lankveld J, Wolfs K, Grauvogl A. Gender Differences in the Relationship of Sexual Functioning with Implicit and Explicit Sex Liking and Sex Wanting: A Community Sample Study. JOURNAL OF SEX RESEARCH 2020; 57:860-871. [PMID: 30489161 DOI: 10.1080/00224499.2018.1542656] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The present study aimed to investigate associations of automatic and controlled cognition with sexual functioning, and moderation of these associations by working memory capacity in a community sample of heterosexual women (N = 65) and men (N = 51). Participants performed two single-target Implicit Association Tests (ST-IATs) to assess implicit liking and wanting of erotic stimuli. The Sexual Opinion Survey (SOS) was used to assess explicit liking of sex. The International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) were used to assess sexual function. Working memory capacity was assessed using the Towers of Hanoi task and mood using the Hospital Anxiety and Depression Scale (HADS). In female participants, higher levels of sexual functioning co-occurred with stronger implicit associations of erotic stimuli with wanting, whereas implicit sex liking was unrelated to level of sexual functioning. In male participants, higher levels of sexual functioning co-occurred with lower implicit liking of erotic stimuli, whereas implicit sex wanting was unrelated to sexual functioning. Higher erotophilia scores were related to higher levels of sexual functioning in both women and men, but anxiety and depression symptoms were unrelated to sexual functioning. Working memory capacity did not moderate the associations between erotophilia and sexual functioning.
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Affiliation(s)
- Jacques van Lankveld
- Department of Psychology and Educational Sciences, Open University of the Netherlands
- AltraCura , Geleen, The Netherlands
| | - Kenny Wolfs
- Department of Psychology and Educational Sciences, Open University of the Netherlands
- AltraCura , Geleen, The Netherlands
| | - Andrea Grauvogl
- Department of Psychology and Educational Sciences, Open University of the Netherlands
- AltraCura , Geleen, The Netherlands
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Simon SC, Greitemeyer T. The impact of immersion on the perception of pornography: A virtual reality study. COMPUTERS IN HUMAN BEHAVIOR 2019. [DOI: 10.1016/j.chb.2018.12.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Velten J, Margraf J, Chivers ML, Brotto LA. Effects of a Mindfulness Task on Women's Sexual Response. JOURNAL OF SEX RESEARCH 2018; 55:747-757. [PMID: 29261339 DOI: 10.1080/00224499.2017.1408768] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Mindfulness-based interventions are effective at improving symptoms of sexual dysfunction in women. The mechanisms by which mindfulness improves sexual function are less clear. The main objective of our study was to investigate the impact of a mindfulness task on sexual response in women. Forty-one women (mean age = 27.2, SD = 5.6) participated in two laboratory sessions that each included two erotic films and one attention task that were presented in counterbalanced order. Both attention tasks consisted of a six-minute audio recording of either a modified body scan, focusing on genital arousal sensations (mindfulness condition), or a visualization exercise. Subjective and genital sexual arousal were measured continuously during stimulus presentation. The mindfulness task led to greater subjective and lower genital arousal. The agreement of subjective and genital sexual arousal (i.e., concordance) was greater in the mindfulness condition. Trait mindfulness was related to lower sexual arousal but also greater sexual concordance in women. Mindfulness-based interventions that encourage women to focus on physical arousal sensations in the here and now may be associated with women's improved sexual function by enhancing feelings of sexual arousal during sexual activity and by increasing concordance between subjective and genital sexual arousal.
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Affiliation(s)
- Julia Velten
- a Mental Health Research and Treatment Center , Ruhr-Universität Bochum
| | - Jürgen Margraf
- a Mental Health Research and Treatment Center , Ruhr-Universität Bochum
| | | | - Lori A Brotto
- c Department of Obstetrics and Gynaecology , University of British Columbia
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Carvalho J, Pereira R, Barreto D, Nobre PJ. The Effects of Positive Versus Negative Mood States on Attentional Processes During Exposure to Erotica. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2495-2504. [PMID: 27734171 DOI: 10.1007/s10508-016-0875-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 09/23/2016] [Accepted: 09/24/2016] [Indexed: 06/06/2023]
Abstract
The relationship between emotions and sexual functioning has been documented since early sex research. Among other effects, emotions are expected to impact sexual response by shaping individuals' attention to sexual cues; yet, this assumption has not been tested. This study aimed to investigate whether attentional processes to sexual cues are impacted by state emotions, and whether the processes impacted by emotions relate to subjective sexual arousal to a sex film clip. A total of 52 men and 73 women were randomly assigned to one of three experimental conditions: (1) a negative mood induction condition (sadness as dominant emotion), (2) a positive mood induction condition (amusement as dominant emotion), and a (3) neutral/control condition. After mood induction, participants were exposed to a sex film clip while their focus of visual attention was measured using an eye tracker. Three areas of interest (AOI) were considered within the sex clip: background (non-sexual cues), body interaction, and genital interaction. Self-reported attention, thoughts during the sex clip, percent dwell time, and pupil size to AOI were considered as attentional markers. Findings revealed that the attentional processes were not impacted by the mood conditions. Instead, gender effects were found. While men increased their visual attention to the background area of the film clip, women increased attention to the genital area. Also, sexual arousal thoughts during exposure to the sex clip were consistently related to subjective sexual arousal regardless of the momentary emotional state. Findings add to the literature by showing that men and women process the sexual components of a stimulus differently and by challenging the assumption that emotions shape attention to sexual cues.
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Affiliation(s)
- Joana Carvalho
- School of Psychology and Life Sciences, Lusófona University, Lisbon, Portugal.
- Center for Psychology at University of Porto, Faculty of Psychology and Educational Sciences, University of Porto, Oporto, Portugal.
| | - Raquel Pereira
- Center for Psychology at University of Porto, Faculty of Psychology and Educational Sciences, University of Porto, Oporto, Portugal
| | - Diana Barreto
- Center for Psychology at University of Porto, Faculty of Psychology and Educational Sciences, University of Porto, Oporto, Portugal
| | - Pedro J Nobre
- Center for Psychology at University of Porto, Faculty of Psychology and Educational Sciences, University of Porto, Oporto, Portugal
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Huberman JS, Maracle AC, Chivers ML. Gender-Specificity of Women's and Men's Self-Reported Attention to Sexual Stimuli. JOURNAL OF SEX RESEARCH 2014; 52:983-995. [PMID: 25255838 DOI: 10.1080/00224499.2014.951424] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Men's sexual arousal is largely dependent on the actor's gender in a sexual stimulus (gender-specific), whereas for women, particularly androphilic women, arousal is less dependent on gender (gender-nonspecific). According to information-processing models of sexual response, sexual arousal requires that attention be directed toward sexual cues. We evaluated whether men's and women's self-reported attention to sexual stimuli of men or women were consistent with genital responses and self-reported arousal. We presented gynephilic men (n = 21) and women (n = 22) and androphilic men (n = 16) and women (n = 33) with audiovisual stimuli depicting men or women engaged in sexual activities. Genital responses were continuously recorded and, following each stimulus, participants reported the amount of attention paid to the video and feelings of sexual arousal. Self-reported attention was gender-specific for men and gender-nonspecific for women, and generally mirrored genital responses and self-reported arousal. Gender-specificity of genital responses significantly predicted gender-specificity of self-reported arousal; however, for men only, this effect was significantly mediated by gender-specificity of self-reported attention. Gender differences in gender-specificity of sexual arousal may be partially accounted for by differences in gender-specificity of self-reported attention, although attention may play a greater role in men's sexual arousal than women's.
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