Implicit and Explicit Associations with Erotic Stimuli in Sexually Functional and Dysfunctional Men

The impact of asexual trait and porn addiction in a young men healthy cohort

In the present study, we aimed to evaluate the association between asexual trait, erectile dysfunction (ED) and porn addiction in a community sample of young men. Between August 2019 and October 2019, a total of 559 young male adults were subjected to an online survey sponsored by social networks with the aim of assessing their sexual habits. The following questionnaires were administered: The International Index of Erectile Function (IIEF-5), Masturbation Erection index (MEI), Pornography Craving Questionnaire (PCQ) and Asexuality Identification Scale (AIS). The overall rate of ED according to IIEF-5 was 26.0% (165/478), the rate of ED according to MEI was 16.9% (81/478) and the rate ED in patients with AIS ≥23 indicating asexual trait was 10.0% (48/478). We found that IIEF-5 was positively associated with MEI (b = 0.32; p < .01) and negatively with AIS (b = -0.36; p < .01) and MEI was negatively associated with AIS (b = -0.36; p < .01). We found that MEI (odds ratio [OR]: 0.86; p < .01) and IIEF-5 (OR: 0.89; p < .01) were inversely associated with asexual trait. The presence of asexual trait can hide a greater risk of finding ED both in intercourse or masturbation. These results should be taken into consideration during the general assessment of the patient with sexual problems.

Gender Differences in the Relationship of Sexual Functioning with Implicit and Explicit Sex Liking and Sex Wanting: A Community Sample Study

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.

Anxiety and Performance in Sex, Sport, and Stage: Identifying Common Ground

Anxiety has long been associated with diminished performance within a number of domains involving evaluative interpersonal interactions, including Sex, Sport, and Stage. Here, we pose three questions: (1) how do these disparate fields approach and understand anxiety and performance; (2) how does the understanding of the issue within one field offer insight to another field; and (3) how could each field benefit from the ideas and strategies used by the others. We begin with a short review of models of anxiety/arousal and performance and then explore definitions, models, presumed underlying physiological processes, and characterizing and influencing factors within each domain separately in a narrative review. This discussion is followed by a synthesis that identifies elements specific to and common across the various domains, with the latter captured in a model of essential characteristics. Concluding remarks note the potential value of promoting increased cross-disciplinary conversation and research, with each domain likely benefiting from the conceptualizations and expert knowledge of the others.

Expectation of sexual images of adults and children elicits differential dorsal anterior cingulate cortex activation in pedophilic sexual offenders and healthy controls

Background

Pedophilic disorder is characterized by increased sexual interest towards children, with comparatively lesser interest towards adults. In real life, the behavior of subjects with pedophilic disorder is shaped by evaluative processes in response to sexually relevant cues. Therefore, brain activation during anticipation of sexually relevant cues is of potential interest. Whereas previous research demonstrated reduced activation when viewing adult (non-preferred) sexual stimuli in pedophilic sex offenders (PSOs), it is not known if anticipation of preferred versus unpreferred stimuli will elicit differential brain activation.

Methods

Two fMRI studies (1.5 and 7 Tesla) were conducted in separate samples, each with 26 subjects (13/13 PSOs/controls) to assess brain activity during expectancy of subsequent adult (non-preferred) sexual stimuli. In the second study (7 Tesla) additionally child (preferred) cues were presented.

Results

As predicted, expectancy of adult sexual stimuli generated smaller dorsal anterior cingulate cortex (dACC) activation in PSOs in both studies, driven by stronger activation during expectancy of adult erotic stimuli in non-pedophilic controls (HCs). In the second study, PSOs showed significantly increased activations in dACC during expectancy of child stimuli compared with expectancy of adult stimuli. This difference was significantly greater compared to the same contrast in HCs, thus demonstrating preference specificity of dACC activation.

Conclusion

Our findings support the notion of decreased brain activation to adult cues in PSOs and preference specificity in neural response during expectancy of erotic stimuli. The localization of these cue reactivity differences in the salience network supports the interpretation that PSOs show abnormally increased preparatory activation even before relevant sexual stimuli are actually presented.

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We studied expectancy-related brain activity in pedophilic offenders and controls.

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Activation during anticipation elicits reactivity differences in salience network.

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Brain activation during expectancy was stronger compared to picture perception.

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Effects in dACC of patients and controls were found in 2 fMRI studies (1.5 and 7 T).

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DACC activation during expectancy revealed preference specificity in both groups.

Assessing Cognitive Appraisals Related to Sexual Function: A Scenario-Based Approach

Cognitive factors play an important role in the etiology and maintenance of sexual difficulties. To date, research has mostly relied on self-report measures to assess negative cognitions related to low sexual function. To overcome the limitations of self-report questionnaires, a series of open-ended, ambiguous sexual scenarios were developed and presented to participants (N = 600, M_age = 34.2 years), who were asked to generate an ending by entering a continuation for each scenario. Valence of completed scenarios was rated by the participants, and scenario endings were coded by two independent raters on three dimensions, namely reference to sexual problems, sexual communication, and the use of sexually explicit language. Sexual function was assessed with the Female Sexual Function Index and the International Index of Erectile Function. Multiple regression analyses were performed to assess whether the scenario-based task was associated with sexual function above and beyond other predictors (e.g., sexual distress). Individuals with lower sexual function rated the completed scenarios more negatively, and their endings included more references to problems related to low sexual function. In women with low sexual function, fewer endings included sexual communication with a partner or sexually explicit language. Our findings suggest that individuals with low sexual function appraise ambiguous sexual situations more negatively than other individuals. Future studies may investigate whether such biases can be experimentally manipulated and whether changes in cognitive biases may, in turn, lead to improvements in sexual function.

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.

Automatic Sex-Liking and Sex-Failure Associations in Men With Sexual Dysfunction

Current models of sexual functioning imply an important role for both automatic and controlled appraisals. Accordingly, it can be hypothesized that erectile dysfunction may be due to the automatic activation of negative appraisals at the prospect of sexual intercourse. However, previous research showed that men with sexual dysfunction exhibited relatively strong automatic sex-positive instead of sex-negative associations. This study tested the robustness of this unexpected finding and, additionally, examined the hypothesis that perhaps more specific sex-failure versus sex-success associations are relevant in explaining sexual dysfunction and distress. Male urological patients (N = 70), varying in level of sexual functioning and distress, performed two Single-Target Implicit Association Tests (ST-IATs) to assess automatic associations of visual erotic stimuli with attributes representing affective valence ("liking"; positive versus negative) and sexual success versus sexual failure. Consistent with the earlier findings, the lower the scores on sexual functioning, the stronger the automatic sex-positive associations. This association was independent of explicit associations and most prominent in the younger age group. Automatic sex-positive and sex-failure associations showed independent relationships with sexual distress. The relationship between sexual distress and sex-failure associations is consistent with the view that automatic associations with failure may contribute to sexual distress.