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Lafortune D, Dussault É, Vaillancourt-Morel MP, Lapointe VA, Blais M, Godbout N. Is Sexual Aversion a Distinct Disorder or a Trans-Diagnostic Symptom across Sexual Dysfunctions? A Latent Class Analysis. JOURNAL OF SEX & MARITAL THERAPY 2023; 50:105-120. [PMID: 37771315 DOI: 10.1080/0092623x.2023.2261933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
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.
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Affiliation(s)
- David Lafortune
- Department of Sexology, Université du Québec à Montréal, Montréal, Canada
| | - Éliane Dussault
- Department of Sexology, Université du Québec à Montréal, Montréal, Canada
| | | | - Valerie A Lapointe
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Martin Blais
- Department of Sexology, Université du Québec à Montréal, Montréal, Canada
| | - Natacha Godbout
- Department of Sexology, Université du Québec à Montréal, Montréal, Canada
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2
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Lakhsassi L, Borg C, Martusewicz S, van der Ploeg K, de Jong PJ. The influence of sexual arousal on subjective pain intensity during a cold pressor test in women. PLoS One 2022; 17:e0274331. [PMID: 36197910 PMCID: PMC9534408 DOI: 10.1371/journal.pone.0274331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/23/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND & OBJECTIVES Pain can be significantly lessened by sex/orgasm, likely due to the release of endorphins during sex, considered potent analgesics. The evidence suggests that endorphins are also present during sexual arousal (that is, prior to sex/orgasm). It follows then that pain can be modulated during sexual arousal, independent of sex/orgasm, too. Accordingly, sexual arousal induced by erotic slides has been demonstrated to lessen pain in men, but not in women. One explanation could be that for women, the erotic slides were not potent enough to elicit a lasting primed state of sexual arousal by the time pain was induced. Thus, the current study aims to optimize the means of inducing a potent state of sexual arousal and subsequently examine the potentially analgesic influence of sexual arousal on pain in women. As a subsidiary aim, the study also assesses whether the anticipated analgesic effect of sexual arousal would be stronger than that of distraction or generalized (non-sexual) arousal. METHODS Female participants (N = 151) were randomly distributed across four conditions: sexual arousal, generalized arousal, distraction, neutral. Mild pain was induced using a cold pressor while participants were concurrently exposed to film stimuli (pornographic, exciting, distracting, neutral) to induce the targeted emotional states. A visual analogue scale was utilized to measure the subjective level of pain perceived by the participants. RESULTS Sexual arousal did not reduce subjective pain. Generalized arousal and distraction did not result in stronger analgesic effects than the neutral condition. CONCLUSION The present findings do not support the hypothesis that sexual arousal alone modulates subjective pain in women. This might be due to the possibility that genital stimulation and/or orgasm are key in pain reduction, or, that feelings of disgust may inadvertently have been induced by the pornographic stimulus and interfered with sexual arousal in influencing pain.
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Affiliation(s)
- Lara Lakhsassi
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
- * E-mail:
| | - Charmaine Borg
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - Sophie Martusewicz
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | | | - Peter J. de Jong
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
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3
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van 't Hof SR, Cera N. Specific factors and methodological decisions influencing brain responses to sexual stimuli in women. Neurosci Biobehav Rev 2021; 131:164-178. [PMID: 34560132 DOI: 10.1016/j.neubiorev.2021.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 08/29/2021] [Accepted: 09/06/2021] [Indexed: 11/19/2022]
Abstract
Most of the neuroimaging studies on sexual behavior have been conducted with male participants, leading to men-based models of sexual arousal. Here, possible factors and methodological decisions that might influence brain responses to sexual stimuli, specifically for the inclusion of women, will be reviewed. Based on this review, we suggest that future studies consider the following factors: menstrual phase, hormonal contraception use, history of sexual or psychiatric disorders or diseases, and medication use. Moreover, when researching sexual arousal, we suggest future studies assess sexual orientation and preferences, that women should select visual sexual stimuli, and a longer duration than commonly used. This review is thought to represent a useful guideline for future research in sexual arousal, which hopefully will lead to a higher inclusion of women and therefore more accurate neurobiological models of sexual arousal.
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Affiliation(s)
| | - Nicoletta Cera
- Centre for Psychology at University of Porto -CPUP, Faculty of Psychology and Education Sciences, University of Porto, Portugal
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Yükselay Ö, Gıca Ş, Yalçın M, Guleç MY, Güleç H. Investigation of auditory P50 sensory gating with sexual visual stimuli in patients with vaginismus. Neurophysiol Clin 2021; 51:251-257. [PMID: 33814257 DOI: 10.1016/j.neucli.2021.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES The aim of the study was to investigate sensory information processing induced by visual sexual stimuli and to assess its relationship with sexual behaviors and symptoms in patients with vaginismus. METHODS Twenty-one patients with vaginismus and 20 controls were included in the study. The sociodemographic information and sexual life history of the patients with vaginismus and controls were examined and electrophysiological measurements related to auditory P50 sensory gating were obtained using a double click paradigm during by sexual/horror visual stimulation, which was thought to be related to the pathophysiology of the disease. RESULTS P50 suppression ratios during visual sexual stimuli were lower in vaginismus group compared to the control group. There was no difference in P50 suppression ratios during visual horror stimuli when the two groups were compared. The P50 suppression of the vaginismus group with visual sexual stimuli was found to be lower than P50 suppression with visual horror stimuli. A positive moderate correlation was found between the duration of foreplay and P50 suppression ratio during visual sexual stimuli in vaginismus group. CONCLUSION Our study revealed that patients with vaginismus had sensory gating impairment during visual sexual stimuli. Increase in the duration of foreplay in vaginismus patients may improve sensory gating impairment by affecting sensory gating functions.
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Affiliation(s)
- Özge Yükselay
- University of Health Sciences, Van Training and Research Hospital, Department of Psychiatry, Istanbul, Turkey
| | - Şakir Gıca
- Necmettin Erbakan University, Meram Medical Faculty, Department of Psychiatry, Konya, Turkey.
| | - Murat Yalçın
- University of Health Sciences, Erenköy Mental and Nervous Diseases Training and Research Hospital, Department of Psychiatry, Istanbul, Turkey
| | - Medine Yazıcı Guleç
- University of Health Sciences, Erenköy Mental and Nervous Diseases Training and Research Hospital, Department of Psychiatry, Istanbul, Turkey
| | - Hüseyin Güleç
- University of Health Sciences, Erenköy Mental and Nervous Diseases Training and Research Hospital, Department of Psychiatry, Istanbul, Turkey
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Arsalidou M, Vijayarajah S, Sharaev M. Basal ganglia lateralization in different types of reward. Brain Imaging Behav 2021; 14:2618-2646. [PMID: 31927758 DOI: 10.1007/s11682-019-00215-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Reward processing is a fundamental human activity. The basal ganglia are recognized for their role in reward processes; however, specific roles of the different nuclei (e.g., nucleus accumbens, caudate, putamen and globus pallidus) remain unclear. Using quantitative meta-analyses we assessed whole-brain and basal ganglia specific contributions to money, erotic, and food reward processing. We analyzed data from 190 fMRI studies which reported stereotaxic coordinates of whole-brain, within-group results from healthy adult participants. Results showed concordance in overlapping and distinct cortical and sub-cortical brain regions as a function of reward type. Common to all reward types was concordance in basal ganglia nuclei, with distinct differences in hemispheric dominance and spatial extent in response to the different reward types. Food reward processing favored the right hemisphere; erotic rewards favored the right lateral globus pallidus and left caudate body. Money rewards engaged the basal ganglia bilaterally including its most anterior part, nucleus accumbens. We conclude by proposing a model of common reward processing in the basal ganglia and separate models for money, erotic, and food rewards.
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Affiliation(s)
- Marie Arsalidou
- Department of Psychology, National Research University Higher School of Economics, Moscow, Russian Federation. .,Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada.
| | - Sagana Vijayarajah
- Department of Psychology, Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
| | - Maksim Sharaev
- Skolkovo Institute of Science and Technology, Moscow, Russian Federation
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6
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Pawłowska A, Borg C, de Jong PJ. Up-regulating Sexual Arousal and Down-regulating Disgust while Watching Pornography: Effects on Sexual Arousal and Disgust. JOURNAL OF SEX RESEARCH 2021; 58:353-363. [PMID: 33378217 DOI: 10.1080/00224499.2020.1863316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
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; µage = 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.
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Affiliation(s)
- Aleksandra Pawłowska
- Department of Clinical Psychology & Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen
| | - Charmaine Borg
- Department of Clinical Psychology & Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen
| | - Peter J de Jong
- Department of Clinical Psychology & Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen
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7
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Sexual Disgust: Evolutionary Perspectives and Relationship to Female Sexual Function. CURRENT SEXUAL HEALTH REPORTS 2019. [DOI: 10.1007/s11930-019-00219-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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8
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Lenk M, Ritschel G, Abele M, Roever P, Schellong J, Joraschky P, Weidner K, Croy I. The source effect as a natural function of disgust in interpersonal context and its impairment in mental disorders. Sci Rep 2019; 9:4239. [PMID: 30862932 PMCID: PMC6414517 DOI: 10.1038/s41598-019-40802-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 02/20/2019] [Indexed: 11/10/2022] Open
Abstract
Disgust affects interpersonal relationships and regulates hygienic, sexual and distance behaviour. Its intensity in the interpersonal context depends on the character of the relationship. Strangers normally evoke more disgust than intimates (known as the source effect). General disgust sensitivity is increased in various mental diseases. It is unclear how disgust in the interpersonal context is affected and whether the source effect is preserved. 460 inpatients with mental disorders and 463 healthy subjects answered a newly developed Questionnaire (DIRQ) that covers disgust in the interpersonal context on content categories (hygiene, physical proximity, sexuality) and on source categories (self, partner, parent, stranger). Mental disorders were diagnosed with structured interviews. Healthy controls exhibited a pronounced source effect, with strangers evoking more disgust than intimates. In patients, this source effect was reduced (Cohen's d = 0.3), especially for sexual disgust, while general disgust sensitivity was increased (d = 0.5). High disgust in patients was best predicted by a history of sexual abuse and by the presence of post-traumatic stress disorder. In conclusion, mentally impaired patients show increased and trauma-associated disgust sensitivity. Their downregulation of sexual disgust in intimate relationships is hindered, which may have a boundary protective function but might also fuel difficulties engaging in relationships or intimacy.
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Affiliation(s)
- Maria Lenk
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany.
| | - Gerhard Ritschel
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany
| | - Marion Abele
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany
| | - Peggy Roever
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany
| | - Julia Schellong
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany
| | - Peter Joraschky
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany
| | - Ilona Croy
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany
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9
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Maturen KE, Akin EA, Dassel M, Deshmukh SP, Dudiak KM, Henrichsen TL, Learman LA, Oliver ER, Poder L, Sadowski EA, Vargas HA, Weber TM, Winter T, Glanc P. ACR Appropriateness Criteria ® Postmenopausal Subacute or Chronic Pelvic Pain. J Am Coll Radiol 2018; 15:S365-S372. [PMID: 30392605 DOI: 10.1016/j.jacr.2018.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 09/07/2018] [Indexed: 10/28/2022]
Abstract
Pelvic pain is common in both reproductive age and postmenopausal women, and the major etiologies change throughout the life cycle. Chronic pain is defined as lasting for at least 6 months. There are many gastrointestinal and urinary disorders associated with chronic pain in this age group, which are not discussed in this guideline. Pain may be localized to the deep pelvis, with potential causes including pelvic congestion syndrome, intraperitoneal adhesions, hydrosalpinx, chronic inflammatory disease, or cervical stenosis. Ultrasound is the initial imaging modality of choice, while CT and MRI may be appropriate for further characterization of sonographic findings. Alternatively, pain may be localized to the vagina, vulva, or perineum, with potential causes including vaginal atrophy, vaginismus, vaginal or vulvar cysts, vulvodynia, or pelvic myofascial pain. Imaging is primarily indicated in context of an abnormal physical exam and ultrasound is the initial modality of choice, while MRI may be appropriate for further characterization in select cases. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
| | | | - Esma A Akin
- George Washington University Hospital, Washington, District of Columbia
| | - Mark Dassel
- Cleveland Clinic, Cleveland, Ohio; American Congress of Obstetricians and Gynecologists
| | | | | | | | - Lee A Learman
- Florida Atlantic University, Boca Raton, Florida; American Congress of Obstetricians and Gynecologists
| | - Edward R Oliver
- Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Liina Poder
- University of California San Francisco, San Francisco, California
| | | | | | | | - Tom Winter
- University of Utah, Salt Lake City, Utah
| | - Phyllis Glanc
- Specialty Chair, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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10
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Spoelstra SK, Weijmar Schultz WCM, Reissing ED, Borg C, Broens PM. The distinct impact of voluntary and autonomic pelvic floor muscles on genito-pelvic pain/penetration disorder. SEXUAL AND RELATIONSHIP THERAPY 2018. [DOI: 10.1080/14681994.2018.1442568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Symen K. Spoelstra
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Willibrord C. M. Weijmar Schultz
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Elke D. Reissing
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Charmaine Borg
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - Paul M.A. Broens
- Department of Surgery, Anorectal Physiology Laboratory, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Ruesink GB, Georgiadis JR. Brain Imaging of Human Sexual Response: Recent Developments and Future Directions. CURRENT SEXUAL HEALTH REPORTS 2017; 9:183-191. [PMID: 29225553 PMCID: PMC5711964 DOI: 10.1007/s11930-017-0123-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE OF REVIEW The purpose of this study is to provide a comprehensive summary of the latest developments in the experimental brain study of human sexuality, focusing on brain connectivity during the sexual response. RECENT FINDINGS Stable patterns of brain activation have been established for different phases of the sexual response, especially with regard to the wanting phase, and changes in these patterns can be linked to sexual response variations, including sexual dysfunctions. From this solid basis, connectivity studies of the human sexual response have begun to add a deeper understanding of the brain network function and structure involved. SUMMARY The study of "sexual" brain connectivity is still very young. Yet, by approaching the brain as a connected organ, the essence of brain function is captured much more accurately, increasing the likelihood of finding useful biomarkers and targets for intervention in sexual dysfunction.
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Affiliation(s)
- Gerben B. Ruesink
- Department of Neuroscience (Section Anatomy), University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, Box 196, 9700 AD Groningen, The Netherlands
| | - Janniko R. Georgiadis
- Department of Neuroscience (Section Anatomy), University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, Box 196, 9700 AD Groningen, The Netherlands
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Levin RJ, Both S, Georgiadis J, Kukkonen T, Park K, Yang CC. The Physiology of Female Sexual Function and the Pathophysiology of Female Sexual Dysfunction (Committee 13A). J Sex Med 2017; 13:733-59. [PMID: 27114190 DOI: 10.1016/j.jsxm.2016.02.172] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/22/2016] [Accepted: 02/24/2016] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The article consists of six sections written by separate authors that review female genital anatomy, the physiology of female sexual function, and the pathophysiology of female sexual dysfunction but excluding hormonal aspects. AIM To review the physiology of female sexual function and the pathophysiology of female sexual dysfunction especially since 2010 and to make specific recommendations according to the Oxford Centre for evidence based medicine (2009) "levels of evidence" wherever relevant. CONCLUSION Recommendations were made for particular studies to be undertaken especially in controversial aspects in all six sections of the reviewed topics. Despite numerous laboratory assessments of female sexual function, genital assessments alone appear insufficient to characterise fully the complete sexual response.
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Affiliation(s)
- Roy J Levin
- Reader in Physiology (Retired), Department of Biomedical Science, University of Sheffield, Sheffield, UK: Section 2.
| | - Stephanie Both
- Department of Psychosomatic Gynecology and Sexology, Leiden University Medical Center, Leiden, The Netherlands: Section 3
| | - Janniko Georgiadis
- Department of Neuroscience, University Medical Center, Groningen, University of Groningen, The Netherlands: Section 4
| | - Tuuli Kukkonen
- College of Social and Applied Human Science, University of Guelph, Guelph, ON, Canada: Section 6
| | - Kwangsung Park
- Department of Urology, Chonnan National University Medical School, Gwangju, Korea: Section 5
| | - Claire C Yang
- Department of Urology, University of Washington, Seattle, WA, USA: Section 1
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13
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Jebelli F, Maaroufi M, Maracy MR, Molaeinezhad M. Effectiveness of eye movement desensitization and reprocessing (EMDR) on the sexual function of Iranian women with lifelong vaginismus. SEXUAL AND RELATIONSHIP THERAPY 2017. [DOI: 10.1080/14681994.2017.1323075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- F. Jebelli
- Department of Psychiatry, School of Medicine, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - M. Maaroufi
- Department of Psychiatry, School of Medicine, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - M. R. Maracy
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - M. Molaeinezhad
- Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Abstract
Progress in understanding the relation between brain profiles and emotions is being slowed by the belief in a collection of basic emotional states, with the names: fear, anger, joy, disgust, and sadness, that do not specify the species or age of the experiencing agent, the origin of the state, or the evidence used to infer it. This article evaluates critically the premise that decontextualized emotional words refer to natural kinds. It also suggests that investigators set aside the currently popular words and search for relations, in humans and animals, between patterns of measures to varied incentives presented in distinctive contexts.
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Affiliation(s)
- Jerome Kagan
- Department of Psychology, Harvard University, USA
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15
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Poeppl TB, Langguth B, Rupprecht R, Safron A, Bzdok D, Laird AR, Eickhoff SB. The neural basis of sex differences in sexual behavior: A quantitative meta-analysis. Front Neuroendocrinol 2016; 43:28-43. [PMID: 27742561 PMCID: PMC5123903 DOI: 10.1016/j.yfrne.2016.10.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 10/02/2016] [Accepted: 10/03/2016] [Indexed: 01/28/2023]
Abstract
Sexuality as to its etymology presupposes the duality of sexes. Using quantitative neuroimaging meta-analyses, we demonstrate robust sex differences in the neural processing of sexual stimuli in thalamus, hypothalamus, and basal ganglia. In a narrative review, we show how these relate to the well-established sex differences on the behavioral level. More specifically, we describe the neural bases of known poor agreement between self-reported and genital measures of female sexual arousal, of previously proposed male proneness to affective sexual conditioning, as well as hints of unconscious activation of bonding mechanisms during sexual stimulation in women. In summary, our meta-analytic review demonstrates that neurofunctional sex differences during sexual stimulation can account for well-established sex differences in sexual behavior.
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Affiliation(s)
- Timm B Poeppl
- University of Regensburg, Department of Psychiatry and Psychotherapy, Universitaetsstrasse 84, 93053 Regensburg, Germany.
| | - Berthold Langguth
- University of Regensburg, Department of Psychiatry and Psychotherapy, Universitaetsstrasse 84, 93053 Regensburg, Germany
| | - Rainer Rupprecht
- University of Regensburg, Department of Psychiatry and Psychotherapy, Universitaetsstrasse 84, 93053 Regensburg, Germany
| | - Adam Safron
- Northwestern University, Department of Psychology, 2029 Sheridan Road, Evanston, IL 60208, United States
| | - Danilo Bzdok
- RWTH Aachen University, Department of Psychiatry, Psychotherapy and Psychosomatics, Pauwelsstrasse 30, 52074 Aachen, Germany; Jülich Aachen Research Alliance (JARA), JARA Brain, Wilhelm-Johnen-Strasse, 52428 Jülich, Germany; INRIA, Neurospin - CEA, Parietal Team, Bât 145, Point Courrier 156, 91191 Gif/Yvette, France
| | - Angela R Laird
- Florida International University, Department of Physics, 11200 SW 8th Street, Miami, FL 33199, United States
| | - Simon B Eickhoff
- Research Centre Jülich, Institute of Neuroscience and Medicine (INM-1), Wilhelm-Johnen-Strasse, 52428 Jülich, Germany; Heinrich Heine University, Institute of Clinical Neuroscience and Medical Psychology, Universitaetsstrasse 1, 40225 Düsseldorf, Germany
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Abstract
PURPOSE OF REVIEW The purpose of this review was to assess recent research (the last 18 months) and its impact on understanding sexual pain disorders relevant to daily clinical practice. RECENT FINDINGS It has been highlighted that sexual pain is related to the number of tender points, pressure pain threshold, more deliberate fear and less global positive affective associations with sexual stimuli, episiotomy, attachment styles, drug abuse and the influence of ambivalence over emotional expression in couples.The efficacy of a multidisciplinary vulvodynia programme of treatment, another type of therapy based on the fear-avoidance and pain self-efficacy model and a novel cognitive-behavioral couple therapy has been stated. SUMMARY There is a gradual advance in the knowledge of sexual pain disorder etiology. At the same time different therapeutics strategies have been increasing, but it is necessary to introduce guidelines on the basis of the evidence to approach with efficacy this severe disorder. VIDEO ABSTRACT http://links.lww.com/YCO/A31.
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Georgiadis JR. Functional neuroanatomy of human cortex cerebri in relation to wanting sex and having it. Clin Anat 2015; 28:314-23. [DOI: 10.1002/ca.22528] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 01/27/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Janniko R. Georgiadis
- Department of Neuroscience/Section Anatomy; University Medical Center Groningen (UMCG), University of Groningen; The Netherlands
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Abstract
PURPOSE OF REVIEW To analyze literature on sexual pain disorders and to review and summarize the articles published throughout 2013 which contribute to the current knowledge on this subject. RECENT FINDINGS By age 40, 7.8% of women reported vulvar pain. Diagnostic and Statistical Manual of Mental Disorders, fifth edition, has combined vaginismus and dyspareunia into the same diagnostic label. The research reviewed in this article seems to differently point toward two conditions, focusing on different aspects both on the etiological and on the treatment area. Higher levels of partner-perceived self-efficacy and lower levels of partner catastrophizing were associated with less pain intensity in women with entry dyspareunia, independent of women's pain perception and self-efficacy. Alexithymia and fear were found to be important etiological factors in vaginismus. SUMMARY The present findings did not provide clear evidence in support of the superiority of any treatment and highlight the need for randomized, placebo-controlled trials that compare treatments in the future. A lot of work remained to be done to understand such a complex and multifaceted disturbance as genital sexual pain, but the articles examined showed that we are slowly adding more knowledge on the etiological cause and treatment models for such conditions.
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Borg C, de Jong PJ, Elgersma H. Sexual aversion and the DSM-5: an excluded disorder with unabated relevance as a trans-diagnostic symptom. ARCHIVES OF SEXUAL BEHAVIOR 2014; 43:1219-1223. [PMID: 25015724 DOI: 10.1007/s10508-014-0341-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Reissing ED, Borg C, Spoelstra SK, Ter Kuile MM, Both S, de Jong PJ, van Lankveld JJDM, Melles RJ, Weijenborg PTM, Weijmar Schultz WCM. "Throwing the baby out with the bathwater": the demise of vaginismus in favor of genito-pelvic pain/penetration disorder. ARCHIVES OF SEXUAL BEHAVIOR 2014; 43:1209-1213. [PMID: 25024064 DOI: 10.1007/s10508-014-0322-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Elke D Reissing
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON, K1C 6N5, Canada,
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van Overveld M, Borg C. Brief Emotion Regulation Training Facilitates Arousal Control During Sexual Stimuli. JOURNAL OF SEX RESEARCH 2014; 52:996-1005. [PMID: 25258109 DOI: 10.1080/00224499.2014.948111] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Disgust, a negative emotion which evokes strong behavioral avoidance tendencies, has been associated with sexual dysfunction. Recently, it was postulated that healthy sexual functioning requires a balance between excitatory (increased sexual arousal) and inhibitory processes (lowered disgust levels). This suggests that amplification of excitatory processes (like sexual arousal) could be a valuable addition to treatments for affect-based sexual dysfunctions. The major aim of the present study was to establish whether up-regulation could effectively enhance arousal levels during sexual stimuli, and whether such a training would simultaneously reduce disgust. Students (N = 163, mean age = 20.73 years, SD = 2.35) were trained in up-regulation of affect using either a sexual arousal film (i.e., female-friendly erotic movie) or a threat arousal film clip (i.e., horror movie), while control groups viewed the films without training instructions. Following this, participants viewed and rated state emotions during a series of pictures (sexual, disgusting, or neutral). Up-regulation of mood successfully enhanced general arousal in both groups, yet these arousal levels were not paralleled by reductions in disgust. Overall, the findings indicate that emotion regulation training by maximizing positive affect and general arousal could be an effective instrument to facilitate affect-related disturbances in sexual dysfunctions.
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Affiliation(s)
| | - Charmaine Borg
- b Department of Clinical Psychology and Experimental Psychopathology , University of Groningen
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