Dysfunctional sexual beliefs: a comparative study of heterosexual men and women, gay men, and lesbian women with and without sexual problems

Factors influencing sexual interest in postmenopausal Asian women

BACKGROUND

The sexual interest of postmenopausal women is a crucial aspect of their overall well-being. Despite its importance, factors influencing postmenopausal sexual interest, particularly in Asian women, remain understudied and poorly understood.

AIMS

To investigate the various factors influencing sexual interest in postmenopausal women in Malaysia.

METHODS

A cross-sectional study was conducted of postmenopausal women attending a gynecology or primary care clinic in a teaching hospital in Malaysia.

OUTCOMES

We investigated how interpersonal dynamics and cultural norms-including the physical and mental health of women and their partners, as well as their sexual values-affect menopausal sexual interest as measured by the Menopausal Sexual Interest Questionnaire.

RESULTS

Women in the study reported an average sexual interest, with a mean score of 32.8 (SD, 9.4) out of 70 on the Menopausal Sexual Interest Questionnaire. Multivariable analysis results showed that higher personal sexual values (odds ratio [OR], 2.65; 95% CI, 1.26-5.61) and spousal sexual values (OR, 2.68; 95% CI, 1.22-5.86) were significantly associated with higher menopausal sexual interest. There was a positive correlation between the physical fitness of spouses and menopausal sexual interest, with women who rated their spouses as very fit or fit (OR, 3.22; 95% CI, 1.15-9.00) or moderately fit (OR, 2.63; 95% CI, 1.05-6.63) showing higher menopausal sexual interest as compared with those whose spouses were very unfit or unfit. Women with normal stress levels (OR, 5.89; 95% CI, 1.03-33.62) and mild to moderate stress levels (OR, 8.13; 95% CI, 1.53-43.22) reported higher menopausal sexual interest.

CLINICAL IMPLICATIONS

This study emphasizes a holistic approach to postmenopausal sexual health, highlighting the significance of promoting positive sexual values, improving physical fitness, and managing stress. Health care providers should educate, counsel, and collaborate interdisciplinarily, ensuring culturally sensitive care tailored to individual needs.

STRENGTH AND LIMITATIONS

The study's strength lies in its provision of valuable insights into factors affecting sexual interest among postmenopausal Asian women, enhancing comprehension of holistic sexual health approaches. However, reliance on self-assessments may introduce response bias influenced by social desirability, and limited generalizability stems from single-site data collection.

CONCLUSION

Our study highlights the significance of adopting a holistic approach to addressing sexual health in postmenopausal women, which includes promoting positive sexual values, improving physical fitness, and managing stress.

Busting MisconSEXions: evaluation of a social media knowledge translation initiative addressing myths about sex

There is a critical gap in sex education such that many people lack access to evidence-based and accessible information about sexuality, putting them at risk for endorsing myths about sex and in turn having poorer sexual wellbeing. To address this gap, we developed a novel social media knowledge translation initiative-MisconSEXions-to debunk common myths about sexuality. The goal of this study was twofold. First, to examine whether exposure to MisconSEXions is effective for reducing sexuality myth endorsement. Second, to evaluate the acceptability (participants' satisfaction with the content), appropriateness (the perceived fit of the content with participants), adoption (participants' intention to engage with the initiative), and penetration (participants' perception of the content's impact on their lives) of MisconSEXions among study participants. We also examined possible group differences in our observed effects by assigned sex, gender modality, and sexual orientation. A large and diverse sample (N = 2,356) of adults completed an online survey and reported on their demographics, sexuality myth endorsement before and after exposure to MisconSEXions content, and the acceptability, appropriateness, adoption, and penetration of the MisconSEXions content. We found that participants' sexuality myth endorsement was significantly lower following exposure to MisconSEXions content, and this effect held across assigned sex, gender modality, and sexual orientation groups. Regardless of participants' assigned sex, gender modality, or sexual orientation, MisconSEXions content was reported to be both acceptable and appropriate to people's lives. Participants reported relatively low levels of adoption, such that they reported reluctance to engage with the content on social media. Additionally, participants reported mixed feelings regarding the impact of the content on their lives (i.e., penetration). Overall, the findings have implications for how sexuality social media knowledge translation initiatives can fill important gaps in providing inclusive and accessible sex education.

A Network Comparison of Sexual Dysfunction, Psychological Factors, and Body Dissociation between Individuals with and without Sexual Trauma Histories

Sexual dysfunction is associated with psychological symptoms, including depression and anxiety. Sexual dysfunctions are often attributed to dissociation symptoms in individuals who reported sexual trauma histories. This study utilized a network approach to analyze relationships between sexual and psychological symptoms and examine whether the identified network structures differed between individuals who reported a history of sexual trauma and those who did not. Sexual dysfunction, history of sexual trauma, internalizing symptoms, dissociation symptoms, sex-related shame, and negative body image were assessed in 1,937 United States college students (women = 69.5%). Nearly half (46.8%) of the participants reported a sexual trauma history in their lifetime. Using regularized partial correlation networks, the relationships between sexual and psychological symptoms were analyzed and compared between groups with and without trauma histories. Internalizing symptoms were positively correlated with sexual dysfunction regardless of the presence of sexual trauma history. Anxiety had a stronger influence in the trauma network than in the no-trauma network. Feeling separated from the body during sexual activity was a central symptom and was related to difficulties relaxing and enjoying sex only in the trauma network. Sex-related shame appeared to play a more important role in men compared to women. To improve clinical practice of assessing and treating sexual dysfunction, researchers and clinicians should consider core symptoms that connect different aspects of sexual and psychological functioning while being aware of the unique role of dissociation in the context of traumatic stress.

The Role of Men's Sexual Beliefs on Sexual Function/Dysfunction: A Systematic Review

Cognitive models of sexual dysfunction postulate that inflexible, unrealistic, and erroneous sexual beliefs work as a vulnerability factor for the development of sexual dysfunctions and existing studies give some support to this hypothesis. However, to date, there is no published systematic review of studies testing the association between men's sexual beliefs and sexual functioning. This systematic review was conducted from searches using EBSCO, PubMed, and Web of Science databases identifying peer-reviewed studies and gray literature sources from inception to November 2021. Twenty cross-sectional studies, assessing correlations between the degree of endorsement of sexual beliefs and sexual functioning and comparing endorsement of sexual beliefs in men with and without sexual problems were included. Despite the small effect sizes, results indicate that higher endorsement of inflexible/unrealistic/erroneous sexual beliefs is associated with poorer sexual functioning and that men presenting with sexual problems tend to report higher endorsement of these sexual beliefs. Further research with clinical samples as well as longitudinal studies are necessary to explore the ways these associations emerge and develop. The state of evidence on this research topic, including gaps and limitations, is discussed.

Stress and Depression Are Associated with Sexual Function and Satisfaction in Young Men Who Have Sex with Men

Prior research suggests that better mental health and higher relationship quality are associated with better sexual function and satisfaction. Such insights can inform intervention development for mental, relationship, and sexual health concerns. This study examined the interactions among these variables in a racially and ethnically diverse group of young men who have sex with men (YMSM) in serious relationships (N = 348). Data were drawn from wave 5 of a longitudinal cohort study. We examined cross-sectional associations between depression and stress (predictors) and sexual function, sexual satisfaction, and anal discomfort (outcomes) and to what extent these associations were moderated by relationship quality. Higher endorsement of depression and stress was associated with worse sexual functioning, lower sexual satisfaction, and more anal discomfort. We also found that fewer negative interactions, stronger commitment, and higher relationship satisfaction were associated with better sexual functioning and higher sexual satisfaction. Higher relationship satisfaction and commitment were found to attenuate the association between stress and sexual satisfaction. Contrary to expectations, higher relationship satisfaction also showed a trend toward exacerbating the association between depression and sexual functioning. These results suggest that, for YMSM, high relationship satisfaction and commitment may protect sexual satisfaction from being negatively impacted by high stress. However, YMSM in highly satisfying relationships may experience poor sexual functioning associated with depression as particularly distressing. This study addressed a major gap in the literature by focusing on mental, relationship, and sexual health in a diverse sample. Future research should examine a wider range of sexual functioning outcomes and include minority stress in study design.

"I was the only one talking about the abuse": Experiences and perceptions of survivors who underwent child sexual abuse as boys

OBJECTIVE

Empirical literature on child sexual abuse (CSA) has traditionally focused on the CSA of girls. Much less is known about the CSA of boys, specifically about the survivors' experiences. The current study was designed to examine the experiences and perceptions of male adult survivors who underwent CSA as boys.

METHOD

Fifty-one written narratives were collected from survivors who experienced CSA as boys as part of the Israeli Independent Public Inquiry into CSA. A qualitative inductive thematic analysis guided the data analysis.

RESULTS

The findings highlighted CSA survivors' experiences of not understanding and confusion about the abuse while highlighting the context in which the abuse took place. The findings also emphasized the exploitation of power and the survivors' difficulty identifying being sexually abused during physical fights or public events. Moreover, the survivors referred to their surroundings' failure to notice the abuse and their struggle to establish their identity and overcome the abuse consequences, their loneliness and pain.

CONCLUSION

The present findings advance the literature on the CSA of boys by examining narratives written by male CSA survivors. They highlight the potentially destructive role of the heteronormative and conventional masculinity discourse for male CSA survivors, which often enabled the continuation of abuse and challenges that survivors continued to face throughout their lives. The findings also stress society's crucial role in CSA prevention and treatment and the need for public education to challenge societal perceptions regarding the CSA of boys.

Hypo- or hyperfunction? Differential relationships between compulsive sexual behavior disorder facets and sexual health

BACKGROUND

Previous studies linking compulsive sexual behavior disorder (CSBD) and sexual health have shown mixed results, which could be due to the fact that different CSBD facets may have differential relationships with sexual functioning.

AIM

As CSBD is a multidimensional disorder, we wanted to investigate whether distinct CSBD domains are differentially related to sexual health.

METHODS

Two online studies were conducted-the first on a convenience sample (812 Polish participants; mean [SD] age, 22.07 [5.91] years) and a replication study on a representative sample of Polish adults (n = 1526; 43.02 [14.37]). Hierarchical regression was employed with sexual functioning as a predicted variable and CSBD symptoms as predictors.

OUTCOMES

The Compulsive Sexual Behavior Disorder Scale was used to assess CSBD symptoms, and the Arizona Sexual Experience Scale was used to measure sexual dysfunction.

RESULTS

In study 1, CSBD salience (β = -.20, P < .001) predicted hyperfunction (ie, stronger sex drive, easier sexual arousal, easier vaginal lubrication/penile erection, easier ability to reach an orgasm, and more satisfying orgasms). Yet, CSBD negative consequences (β = .15, P = .001) and dissatisfaction (β = .22, P < .001) predicted hypofunction (ie, weaker sex drive, more difficulties in sexual arousal, greater difficulties in vaginal lubrication/penile erection, less ability to reach an orgasm, and less satisfying orgasms). Similar results were found in study 2: salience (β = -.26, P < .001) and relapse (β = -.11, P = .004) predicted hyperfunction, while negative consequences (β = .12, P < .001) and dissatisfaction (β = .12, P < .001) predicted hypofunction.

CLINICAL IMPLICATIONS

Our results stress the importance of assessing the severity of each group of symptoms in patients with CSBD to better understand possible difficulties in their sexual functioning.

STRENGTHS AND LIMITATIONS

Our studies are the first to evaluate the effects of each CSBD domain on sexual health. We also replicated results obtained from a convenience sample on a representative sample. The cross-sectional design of the current studies does not allow causal relations to be tested, so future longitudinal research should be carried out. We also gathered data from a general population-thus, it is important to replicate these results on patients diagnosed with CSBD.

CONCLUSION

Our research points out the differential impact of CSBD domains on sexual health: salience and relapse are related to sexual hyperfunction, while negative consequences and dissatisfaction to hypofunction.

Sexual functioning beliefs, sexual satisfaction, and sexual functioning in women: a cross-sectional mediation analysis

BACKGROUND

Sexual dysfunctional beliefs are known to be negative predictors of women's sexual functioning and sexual satisfaction, but little is known about the role that beliefs about sexual functioning play in women's sexual functioning and sexual satisfaction.

AIM

The purpose of the present study was to examine the mediating role of sexual functioning in the relationship between women's beliefs about sexual functioning and sexual satisfaction.

METHODS

A sample of 301 women was invited to participate in a web survey about female sexuality in May 2020.

OUTCOMES

Participants completed the sociodemographic questionnaire, the Beliefs About Sexual Functioning Scale, the Sexual Satisfaction Scale for Women, and the Female Sexual Functioning Index.

RESULTS

Sexual functioning was a significant mediator in the relationship between beliefs about sexual functioning and sexual satisfaction in women. When the dimensions of sexual functioning were considered as mediators, only sexual desire and absence of sexual pain were significant mediators in the relationship between beliefs about sexual functioning and sexual satisfaction in women.

CLINICAL IMPLICATIONS

Negative beliefs about sexual functioning in women are associated with poor sexual functioning and lack of sexual satisfaction. Therefore, beliefs about sexual functioning should be assessed during the intervention for women's sexual difficulties and to increase sexual pleasure and satisfaction. In addition, special attention should be paid to women with problems with sexual desire and sexual pain when beliefs about sexual functioning are being assessed.

STRENGTHS AND LIMITATIONS

This study is one of the first attempts to explore the role of beliefs about sexual functioning in women's sexual satisfaction and to examine the mediating role of sexual functioning. Limitations include the small sample size, the lack of a clinical sample, and the nonlongitudinal methodological approach.

CONCLUSION

Beliefs about sexual functioning are a negative predictor of sexual functioning and sexual satisfaction in women. In addition, women with sexual pain and lack of sexual desire are more likely to have lower sexual satisfaction if they have more negative beliefs about sexual functioning.

"I'm Too Old for That": The Role of Ageism and Sexual Dysfunctional Beliefs in Sexual Health in a Sample of Heterosexual and LGB Older Adults: A Pilot Study

The role of ageism (i.e., discrimination against individuals or groups on the basis of their age), in particular toward the sexuality of the elderly, remains, to date, an overlooked issue. A few studies have suggested that ageistic stereotypes can negatively affect older adults' sexual health. No data are available, in particular, about differences among heterosexual and LGB (lesbian, gay, and bisexual) populations. The present study aimed to investigate differences in perceived ageism and related dysfunctional beliefs in a sample of heterosexual (n = 104) and LGB (n = 103) older adults (aged 55 or older; mean age 66.5) and their impact on sexual health and satisfaction. LGB individuals reported higher rates of masturbation and sexual intercourse and an increased quality of sexual activity as compared to heterosexuals. In addition, no differences between the groups emerged as regards perceived ageism and dysfunctional beliefs toward ageing. In conclusion, LGB individuals perceived more ageism toward sexuality than their counterparts; however, heterosexuals were more likely to have dysfunctional beliefs toward sexuality in ageing. The study findings highlight the significance of examining sexual orientation to understand experiences of sexuality in ageing of the growing older population. Renewed socio-educational efforts based on these data are clearly needed.

Endometriosis and Sexual Functioning: How Much Do Cognitive and Psycho-Emotional Factors Matter?

Women with endometriosis often suffer from genito-pelvic pain. The objective of the present study was to analyze the relationship between cognitive and psycho-emotional factors and sexual functioning of women with endometriosis, comparing women with and without endometriosis. A total of 87 women with endometriosis (EG) and 100 women without endometriosis (CG) completed a socio-demographic questionnaire; the short-form of McGill Pain Questionnaire (SF-MPQ); the Female Sexual Functioning Index (FSFI); the Sexual Distress Scale (SDS); the Symptoms Checklist (SCL-90-R); the Toronto Alexithymia Scale (TAS-20); the Positive and Negative Affects Scale (PANAS); the Sexual Dysfunctional Belief Questionnaire (SDBQ); the Sexual Modes Questionnaire (SMQ); and the Questionnaire of Cognitive Schema Activation in Sexual Context (QCSASC). EG obtained worse scores than CG in SF-MPQ, Pain subscale of FSFI, and SDS. EG reached higher scores than CG on almost all scales of SCL-90-R and lower scores in the “Identifying Feelings” scale of TAS-20. Furthermore, EG reported more negative emotions toward sexuality than CG (PANAS) higher scores on the “Affection Primacy” scale of SDBQ and the “Helpless” sexual cognitive schema of QCSASC than CG. No significant differences were found in SMQ. Sexual health professionals should address psychological, emotional, and cognitive factors since they seem involved in patients’ sexual experiences.

Sexual Health and the Pandemic Crisis: Testing the Role of Psychological Vulnerability/Protective Factors on Sexual Functioning and Sexual Distress During a Critical Life Period in Portugal

Recent findings suggest that the current COVID-19 pandemic has a potential negative impact in several areas of life, including sexual health. However, less is known about the psychological dimensions that may work as vulnerability/protective factors for the development of sexual problems in the current pandemic. The current study used a longitudinal design to examine the role played by personality trait factors (neuroticism, extraversion) as well as psychosexual factors (sexual beliefs) in predicting sexual functioning and sexual distress across time during the current pandemic crisis. A total of 528 individuals (337 women) completed a web survey assessing sexual health indicators and psychological factors. The first wave was conducted during the confinement period in Portugal (N = 528) between May and June 2020 and the second four months later (N = 146), when strict confinement rules were over. Generalized estimating equations (GEE) were used to examine the ability of psychological factors to predict sexual functioning and distress across time, while controlling for age and gender. Results indicated that sexual distress at time point 2 was lower than during confinement, and men had lower levels of sexual functioning post-confinement while no significant difference was observed for women. Moreover, higher levels of neuroticism and age-related beliefs significantly predicted lower sexual functioning as well as higher sexual distress, whereas lower levels of extraversion predicted lower sexual functioning after controlling for age and gender effects. Findings support the role of psychological vulnerability factors to predict sexual problems across time and may have important implications in the prevention and treatment of sexual dysfunctions.

Associations between Cues of Sexual Desire and Sexual Attitudes in Portuguese Women

Sexuality is defined as a multidimensional experience that involves genital, mental, and bodily components. It is also assumed as a basic condition inherent to the human existence that encourages the search for love, intimacy, sex, and proximity to others. The main objective of this study is to assess the relationship between cues of sexual desire and sexual attitudes in Portuguese women. This is a cross-sectional study with 804 Portuguese women to whom the protocol was applied. It included an informed consent, a sociodemographic questionnaire, a questionnaire related to intimacy, a scale of sexual attitudes, and the scale of cues of sexual desire. The protocol was applied via Google Forms due to the current pandemic situation (COVID-19). Differences were found in sexual attitudes and the cues of sexual desire in terms of sociodemographic characteristics, as well as in terms of women's intimacy. Significant correlations were found between the brief sexual attitudes scale (BSAS) and the cues of sexual desire scale (CSDS). Age, sexual orientation, relation nature, sexual practices, visual proximity cues, erotic explicit cues, and sensory explicit cues explain, altogether, 25% of the total sexual attitudes. Additionally, age, sexual orientation, the relation's nature, sexual practices, visual proximity cues, emotional bonding cues, romantic implicit cues, erotic explicit cues, and sensory explicit cues explain, altogether, 30% of the permissiveness. Sexual attitudes are developed under the influence of sociodemographic variables, variables related to women's intimacy, and cues of sexual desire, which are new data in the study of sexual attitudes and have implications at the level of gender issues.

Individual, Relational, and Sociocultural Determinants of Sexual Function and Sexual Satisfaction in Ecuador

Aim

Various individual, relational, and sociocultural variables have been identified as determinants of sexual responding, but these have rarely been investigated in non-Western cultures that are characterized by sexual conservatism. We aimed to explore the role of socioeconomic status and religion, sexual double standards, erotophobia-erotophilia, sexual dysfunctional beliefs, and relationship satisfaction to explain sexual function and satisfaction in Ecuador.

Method

599 participants (431 women and 159 men) completed an online survey.

Main Outcomes Measures

The Female sexual function was predicted by sexual satisfaction, relationship satisfaction, sexual dysfunctional beliefs, and sexual double standards, while the male sexual function was predicted solely by sexual satisfaction. Additionally, female sexual satisfaction was predicted by sexual function, relationship satisfaction, and sexual dysfunctional beliefs, while male sexual satisfaction was predicted by sexual function and relationship satisfaction.

Results

Female Sexual Function Index, International Index of Erectile Function, Brief Sexual Opinion Survey, Sexual Double Standards Scale, Sexual Dysfunctional Beliefs Questionnaire, New Sexual Satisfaction Scale, and Couple Satisfaction Index.

Conclusion

This study provided novel information on the determinants of sexual function and satisfaction within a culture in which conservative religious beliefs still prevail. Results should be interpreted with caution given the unequal distribution of men and women, social desirability and volunteer biases, and the specific COVID-19 pandemic context during which the survey took place. Markers of sexual conservatism were inversely related to sexual function and satisfaction, mainly in women, and may, therefore, be important targets of treatment. Female sexuality seemed more context-dependent than male sexuality, although enhancing the general climate of the relationship may benefit feeling sexually satisfied in both men and women. DA Hidalgo, M Dewitte. Individual, Relational, and Sociocultural Determinants of Sexual Function and Sexual Satisfaction in Ecuador. Sex Med 2021;9:100307.

Sexual function in women with androgen excess disorders: classic forms of congenital adrenal hyperplasia and polycystic ovary syndrome

PURPOSE

We compared the sexual function in women with classic forms of congenital adrenal hyperplasia (CAH) and polycystic ovary syndrome (PCOS) to find if the cause of androgen excess determines sexual functioning.

METHODS

Hundred and four women (21 with CAH, 63 with PCOS and 20 healthy controls) aged 18-40 years were included into the study. All participants completed a questionnaire regarding their sociodemographic background and underwent anthropometric and basic biochemical measurements. Plasma levels of total testosterone, androstenedione, and 17-hydroxyprogesterone were measured with immunoassay. To assess the sexual functions, the Female Sexual Function Index (FSFI) questionnaire was applied.

RESULTS

Apart from the higher physical activity in PCOS patients (P = 0.017), we found no significant sociodemographic differences between the studied groups. In clinical assessment, women with CAH had a lower incidence of acne (P = 0.006). Their plasma levels of 17OHP (P = 0.005) and insulin resistance index (P = 0.0248) were higher, while total testosterone (P = 0.0495) and glucose (P = 0.0061) was lower compared to the PCOS group. Significantly more women with CAH were homosexual (P = 0.003) and bisexual (P = 0.006). CAH group showed a lower total FSFI score (P = 0.0043) and lower scores in three domains: lubrication (P = 0.0131), sexual satisfaction (P = 0.0006), and dyspareunia (P < 0.0001). Higher physical activity was associated in all women with higher total FSFI score (P = 0.009) and scores in the domain of desire (P = 0.034) and sexual satisfaction (P = 0.01), while in CAH women apart from the total score (P = 0.03) and sexual satisfaction (P = 0.002) also in the domains of orgasm (P = 0.005), and pain (P = 0.03).

CONCLUSIONS

CAH women present more often homosexual and bisexual orientation, while their sexual functions are impaired compared to PCOS patients.

Sexual Dysfunction Among Men Who Have Sex with Men: a Review Article

PURPOSE OF REVIEW

The goal of this review article is to evaluate sexual dysfunction among men who have sex with men (MSM).

RECENT FINDINGS

Men who have sex with men are commonly affected by sexual dysfunction. Often sexual dysfunction in MSM will significantly impact their psychological well-being perhaps even more than their heterosexual counterparts. Despite the frequency and high impact of sexual dysfunction in MSM, access to appropriate care may be limited. It is important for urologists, especially sexual medicine clinicians, to be aware of and comfortable with differences in sexual practices of MSM. Penile pathology in this patient population will negatively affect their quality of life and well-being. Therefore, it is important to properly assess and treat these patients.

Sexual Desire and Fantasies in the LGBT+ Community: Focus on Lesbian Women and Gay Men

Purpose of Review

The purpose of this review is to summarize the current knowledge around sexual desire, fantasies, and related biopsychosocial factors that may facilitate or obstruct sexual expressions in lesbian women and gay men.

Recent Findings

Sexual desire levels and related problems do not seem significantly different in people who identify as gay or lesbian compared to their heterosexual counterparts. Evidence has shown lesbian women and gay men may have specific desire expressions and biopsychosocial factors influencing their sexual health. This may suggest the importance of deepening the understanding of the unique factors of LGBT+ sexuality and relationships while paying attention to the sociocultural background in which lesbian and gay people grow and develop their identities.

Summary

A lack of specific and unbiased literature on sexual desire and fantasies in gay and lesbian people is reported. Available evidence is controversial and often biased. LG people showed a variety of sexual expressions that are hard to categorize referring to the heteronormative sexual standards that permeate literature and clinical practice. Implications for future research and clinical practice are discussed.

Cognitive-Emotional Predictors of Sexual Functioning in Lesbians, Gays, and Heterosexuals

Cognitive-emotional dimensions play a core role in predisposing and maintaining sexual difficulties. This study aimed to assess the role of personality traits, sexual beliefs, cognitive schemas, automatic thoughts and affective states in predicting sexual functioning in a Portuguese sample. A total of 226 lesbian women, 254 heterosexual women, 243 gay men, and 274 heterosexual men completed a web-survey. For each sample, hierarchical regression analyses were conducted, separately. Results indicated that positive affective states and fewer thoughts associated with failure and disengagement during sexual activity act as significant predictors for sexual functioning, in both lesbian and heterosexual women's groups. Specific predictors of better sexual functioning in lesbian women were lower activation of schemas of undesirability and incompetence, and fewer thoughts associated with sexual abuse, body-image and sexual passivity were, whereas particular predictors of better sexual functioning for heterosexual women were erotic thoughts, lower activation of schemas of undesirability and difference/loneliness, and beliefs related to sexual desire as a sin. For men's groups, the best predictor of sexual functioning was the presence of erotic thoughts. Particularly for gay men's group, fewer failure anticipation thoughts were also a predictor of better sexual functioning. Overall, this study supports the core and predictive role of cognitive-emotional dimensions in sexual functioning for lesbian and heterosexual women, as for gay and heterosexual men.

Implicit and Explicit Associations with Erotic Stimuli in Women with and Without Sexual Problems

Conceptual models of sexual functioning have suggested a major role for implicit cognitive processing in sexual functioning. The present study aimed to investigate implicit and explicit cognition in sexual functioning in women. Gynecological patients with (N = 38) and without self-reported sexual problems (N = 41) were compared. Participants performed two Single-Target Implicit Association Tests (ST-IAT), measuring the implicit association of visual erotic stimuli with attributes representing, respectively, valence and motivation. Participants also rated the erotic pictures that were shown in the ST-IATs on the dimensions of valence, attractiveness, and sexual excitement, to assess their explicit associations with these erotic stimuli. Participants completed the Female Sexual Functioning Index and the Female Sexual Distress Scale for continuous measures of sexual functioning, and the Hospital Anxiety and Depression Scale to assess depressive symptoms. Compared to nonsymptomatic women, women with sexual problems were found to show more negative implicit associations of erotic stimuli with wanting (implicit sexual motivation). Across both groups, stronger implicit associations of erotic stimuli with wanting predicted higher level of sexual functioning. More positive explicit ratings of erotic stimuli predicted lower level of sexual distress across both groups.

The Activation of Incompetence Schemas in Response to Negative Sexual Events in Heterosexual and Lesbian Women: The Moderator Role of Personality Traits and Dysfunctional Sexual Beliefs

Personality traits and dysfunctional sexual beliefs have been described as vulnerability factors for sexual dysfunction in women, and have also been proposed as dispositional variables for the activation of incompetence schemas in response to negative sexual events. However, no study has tested the role of personality traits and dysfunctional sexual beliefs in the activation of incompetence schemas. The current study aimed to assess the moderator role of neuroticism, extraversion, and dysfunctional sexual beliefs in the association between frequency of unsuccessful sexual episodes and activation of incompetence schemas in heterosexual and lesbian women. An online survey was completed by 1,121 women (831 heterosexual; 290 lesbian). Participants completed the NEO Five-Factor Inventory (NEO-FFI), the Sexual Dysfunctional Beliefs Questionnaire-Female Version (SDBQ), and the Questionnaire of Cognitive Schemas Activated in Sexual Context (QCSASC). Findings indicate that neuroticism moderates the association between frequency of negative sexual events and activation of incompetence schemas in heterosexual women. Moreover, several sexual beliefs also act as moderators of the relationship between negative sexual episodes and the activation of cognitive schemas in both heterosexual and lesbian women. Overall, findings support the cognitive-emotional model of sexual dysfunctions, emphasizing the role of personality traits and dysfunctional sexual beliefs as facilitators of the activation of incompetence schemas in response to negative events in women.

A Place for Sexual Dysfunctions in an Empirical Taxonomy of Psychopathology

Sexual dysfunctions commonly co-occur with various depressive and anxiety disorders. An emerging framework for understanding the classification of mental disorders suggests that such comorbidity is a manifestation of underlying dimensions of psychopathology (or "spectra"). In this review, we synthesize the evidence that sexual dysfunctions should be included in the empirical taxonomy of psychopathology as part of the internalizing spectrum, which accounts for comorbidity among the depressive and anxiety disorders. The review has four parts. Part 1 summarizes the empirical basis and utility of the empirical taxonomy of psychopathology. Part 2 reviews the prima facie evidence for the hypothesis that sexual dysfunctions are part of the internalizing spectrum (i.e., high rates of comorbidity; shared cognitive, affective, and temperament characteristics; common neural substrates and biomarkers; shared course and treatment response; and the lack of causal relationships between them). Part 3 critically analyzes and integrates the results of the eight studies that have addressed this hypothesis. Finally, Part 4 examines the implications of reconceptualizing sexual dysfunctions as part of the internalizing spectrum, and explores avenues for future research.

Automatic Thoughts During Sexual Activity, Distressing Sexual Symptoms, and Sexual Orientation: Findings from a Web Survey

Studies with heterosexual samples have supported the role of cognitions on sexual functioning in men and women. However, there is no research on the impact of automatic thoughts on sexual functioning in sexual-minority samples. Therefore, the current study aimed to analyze the differences in automatic thoughts during sexual activity between gay and heterosexual men, and lesbian and heterosexual women, with and without distressing sexual symptoms, in order to establish similarities and differences between samples. A web survey was completed by 156 men and 168 women. A group of men and women with distressing sexual symptoms (78 men and 84 women) and a group without distressing sexual symptoms (78 men and 84 women) equally distributed in terms of sexual orientation and matched for sociodemographic variables were constituted. Participants answered a sociodemographic questionnaire, a questionnaire about sexual symptoms, and an automatic thoughts measure. Main findings suggested that men and women with distressing sexual symptoms reported significantly more negative automatic thoughts and fewer erotic thoughts during sexual activity, regardless of sexual orientation. Overall, current findings were consistent with previous research with heterosexual samples, suggesting a similar pattern in heterosexual samples, and gay men and lesbian women samples.

Sexual Dysfunctional Beliefs Questionnaire (SDBQ): Translation and Psychometric Properties of the Iranian Version

INTRODUCTION

The sexual dysfunctional beliefs questionnaire (SDBQ) is a validated measure for assessing dysfunctional sexual beliefs.

AIMS

The aim of this study was to translate and validate the SDBQ to Iranian context.

METHODS

In order to translate the questionnaire from English into Persian, a forward-backward procedure was applied. After linguistic validation, the psychometric properties of the Iranian version were assessed for both men and women. A total of 387 participants (226 women and 161 men) completed the SDBQ.

MAIN OUTCOME MEASURES

A principle component analysis with varimax rotation was performed for both the male and female samples. Reliability was evaluated by calculating Cronbach's alpha (internal consistency) and test-retest coefficients (intraclass correlation coefficient).

RESULTS

The results from the principle component analysis identified six factors in the female version: sexual conservatism and female sexual passivity, beliefs about masturbation, body image beliefs, sexual desire and pleasure as a sin, age-related beliefs, and denying affection primacy. In the male version six factors were also identified: sex as an abuse of men's power, beliefs related to women's satisfaction, sexual conservatism, female sexual power, "macho" beliefs, and restrictive attitudes toward sex. Findings support the original six-factor solution for the male sample. For the female sample, although a six-factor solution was found, original motherhood-related beliefs were included in the sexual conservatism and female sexual passivity factor, and a new dimension has emerged, related to masturbation beliefs. Additionally, results indicated that the SDBQ had good internal consistency and test-retest reliability in both male and female versions.

CONCLUSION

Current findings support the reliability and validity of the SDBQ in an Iranian sample and suggest its applicability to assess sexual beliefs in both clinical samples and the general population in Iran.

Personality Traits, Sexual Problems, and Sexual Orientation: An Empirical Study

Personality traits, namely neuroticism, have been suggested as vulnerability factors for the development and maintenance of sexual dysfunction in heterosexual samples. However, no evidence was found regarding homosexual samples. This study aimed to analyze the differences on personality traits between heterosexual and homosexual men and women with and without sexual problems. Participants were 285 individuals (142 men, 143 women) who completed a web-based survey. Participants answered the NEO Five-Factor Inventory, the Brief Symptomatology Inventory, and questions regarding sexual problems. The groups of men and women with and without sexual problems were matched for sociodemographic variables. A 2 (Group) × 2 (Sexual Orientation) multivariate analysis of covariance was conducted separately for each gender. Results indicated a significant main effect for group and for sexual orientation in male and female samples. Men with sexual problems scored higher on neuroticism, whereas women with sexual problems scored higher on neuroticism and lower on extraversion when compared with healthy controls, regardless of sexual orientation. In addition, gay men scored higher on neuroticism and lesbian women scored higher on conscientiousness compared with the heterosexual groups. The present findings emphasize the central role of neuroticism on sexual problems in both men and women regardless of sexual orientation.