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Jobim Fischer V, Rossato Holz M, Billieux J, Andersson G, Vögele C. Web-Based Emotion Regulation Training for Sexual Health: Randomized Controlled Trial. JMIR Form Res 2024; 8:e50850. [PMID: 38568720 PMCID: PMC11024748 DOI: 10.2196/50850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/29/2023] [Accepted: 01/11/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Effective emotional regulation (ER) skills are important for sexual function, as they impact emotional awareness and expression during sexual activity, and therefore, satisfaction and distress. Emotion regulation interventions may offer a promising approach to improve sexual health. Web-based emotion regulation may be a therapeutic strategy for men and women with sexual health concerns. Nevertheless, there is a scarcity of intervention trials investigating its effects in this context, much less using the internet. OBJECTIVE This study aims to investigate the effects of a web-based emotion regulation training program for sexual function in both men and women. METHODS The participants were recruited based on their self-reported sexual problems, which for men was defined by a score of <25 on the International Index Erectile Function (IIEF) and for women by a score of <26.55 on the Female Sexual Function Index (FSFI). The final sample included 60 participants who were randomized to either a web-based emotion regulation training for sexual function or to a waitlist control group. The treatment consisted of an 8-week web-based emotion regulation training for sexual function. The participants were assessed at baseline, post intervention, and the 3-month follow-up. RESULTS Of the 60 participants included, only 6 completed all 3 assessment points (n=5, 20% in the treatment group and n=1, 5% in the waitlist control group) after receiving the intervention. At follow-up, there were no significant differences between groups in any measure. Among the intervention completers, large-to-moderate within-group effect sizes were observed between the assessment points on measures of emotion regulation, depression, lubrication, orgasm, thoughts of sexual failure, and abuse during sexual activity. The adherence rate was very low, limiting the generalizability of the findings. CONCLUSIONS Participants who completed the intervention showed improvements in both sexual function domains and emotion regulation. Nonetheless, due to a high dropout rate, this trial failed to collect sufficient data to allow for any conclusions to be drawn on treatment effects. TRIAL REGISTRATION ClinicalTrials.gov NCT04792177; https://clinicaltrials.gov/study/NCT04792177.
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Affiliation(s)
- Vinicius Jobim Fischer
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | | | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Gerhard Andersson
- Department of Behavioural Science and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Claus Vögele
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Fischer VJ, Andersson G, Billieux J, Infanti A, Vögele C. The Role of Emotion Regulation Strategies for Sexual Function and Mental Health: A Cluster Analytical Approach. J Sex Marital Ther 2023; 50:123-136. [PMID: 37822263 DOI: 10.1080/0092623x.2023.2264863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
We investigated distinct profiles in emotion regulation strategies (reappraisal and suppression) and their associations with sexual function and mental health. The online survey sample consisted of 5436 adult participants. The gender stratified cluster analysis resulted in a four-cluster solution for both men and women. Better sexual function and mental health scores were found for participants with high cognitive reappraisal and low expressive suppression. High expressive suppression was associated with higher anxiety and depression and worse sexual function. Sexological care should take into account the assessment of emotion regulation abilities and emotion regulation training interventions to support reappraisal strategies.
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Affiliation(s)
- Vinicius Jobim Fischer
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Gerhard Andersson
- Department of Behavioural Science and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Alexandre Infanti
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Claus Vögele
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Hensel DJ, Mark KP, Abdelhamed A, Burns S, Esho T, Hendriks J, Jobim Fischer V, Ivanova O, Marks M, Michelsen K, Nimby F, Strizzi J, Tucker J, Uhlich M, Erausquin JT. Changes in Solo and Partnered Sexual Behaviors following the First COVID-19 Wave: Data from an International Study of 26 Countries. Int J Sex Health 2023; 35:459-480. [PMID: 38601728 PMCID: PMC10903556 DOI: 10.1080/19317611.2023.2224777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/21/2023] [Accepted: 05/28/2023] [Indexed: 04/12/2024]
Abstract
Objective To determine individual- and country-level factors associated with self-reported changes in solo and partnered sexual behaviors in an international sample of adults during COVID-19. Methods Data were from the International Sexual Health And REproductive Health during COVID-19 study (I-SHARE)-a cross-sectional, multi-country study (N = 26 countries) assessing adult (N = 19,654) sexual/reproductive health before and during the first wave of COVID-19. We examined self-reported changes (three-point scale: decreased, no change, increased) in solo masturbation, hugging/holding hands/cuddling with a partner, sex with a primary partner, sex with a casual partner, sexting with a partner, viewing sexually explicit media and partnered cybersex. Ordinal regression assessed the impact of individual (age, gender- and sexual-identity, romantic partnership status, employment and income stability, household change and content, mental well-being, changes in alcohol use, and changes in marijuana use) and country-level (e.g., Oxford Stringency Index, Human Development Index, and the Palma Ratio) factors on behavior change. Results The most common behavior to increase was hugging, kissing, or cuddling with a partner (21.5%), and the most common behavior to decrease was sex with a main partner (36.7%). Household factors like job/income instability and having children over the age of 12 years were significantly associated with decreased affectionate and sexual partnered sexual behaviors; more frequent substance use was linked to significantly increased solo, partnered, and virtual sexual behaviors. Conclusions Understanding changes in sexual behaviors-as well as the factors that make changes more or less likely among adults around the world-are important to ensure adequate sexual health support development for future public health emergencies.
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Affiliation(s)
- Devon J. Hensel
- Division of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Sociology, Indiana University Purdue University-Indianapolis, Indianapolis, IN, USA
| | - Kristen P. Mark
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Amr Abdelhamed
- Department of Dermatology, Venereology & Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Sharyn Burns
- Discipline of Health Promotion & Sexology, Curtin School of Population Health, Curtin University, Perth, Australia
| | | | - Jacqueline Hendriks
- Discipline of Health Promotion & Sexology, Curtin School of Population Health, Curtin University, Perth, Australia
| | - Vinicius Jobim Fischer
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Olena Ivanova
- Department of Infectious Diseases, University Hospital LMU Munich, Munich, Germany
| | - Michael Marks
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Kristien Michelsen
- Department of Public Health and Primary Care, University of Ghent, Ghent, Belgium
| | - Fillipo Nimby
- Foundation for Professional Development, Rome, Italy
| | - Jenna Strizzi
- Centre for Medical Science and Technology Studies, University of Copenhagen, Copenhagen, Denmark
| | - Joe Tucker
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Fischer VJ, Bravo RG, Brunnet AE, Michielsen K, Tucker JD, Campbell L, Vögele C. Sexual satisfaction and sexual behaviors during the COVID-19 pandemic: results from the International Sexual Health And REproductive (I-SHARE) health survey in Luxembourg. BMC Public Health 2022; 22:1108. [PMID: 35658847 PMCID: PMC9163902 DOI: 10.1186/s12889-022-13509-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/18/2022] [Indexed: 11/30/2022] Open
Abstract
AIM To identify the impact of COVID-19 measures on sexual behaviors and sexual satisfaction in Luxembourg residents. METHODS We conducted a cross-sectional online survey of adults (> 18 years of age) residing in Luxembourg, while COVID-19 restrictions were in place. The survey was available from January 15 to February 12, 2021 in four languages (French, German, English and Portuguese). Survey questions focused on masturbation, cuddling, condom use, sex frequency, sexting, cybersex, watching porn, and sexual satisfaction. RESULTS 557 volunteers completed the survey (35.5% men, 64.3% women). Sexual satisfaction and sexual problems variables were assessed on 4-point Likert scales (0 = not at all/never to 3 = very/often). Sexual problems increased during the COVID-19 measures while sexual satisfaction decreased compared to before the introduction of COVID-19 restrictions (assessed retrospectively). Factors associated with increased odds of sexual satisfaction included having a steady relationship before COVID-19 restrictions, engaging in sexting, reporting good mental health and not altering alcohol intake. CONCLUSIONS The context of the COVID-19 pandemic and the measures implemented in Luxembourg affected sexual behaviors and sexual satisfaction. Sexual and reproductive health care centers and health professionals in general should take these results into consideration when providing care. Recommendations on the importance of sexual health for general wellbeing and behaviors associated with sexual satisfaction should be offered and possibilities to experience sexuality while reducing contamination risks be discussed.
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Affiliation(s)
- Vinicius Jobim Fischer
- Research Group Self-Regulation and Health, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
| | - Raquel Gómez Bravo
- Research Group Self-Regulation and Health, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Alice Einloft Brunnet
- Laboratoire Clinique Psychanalyse Développement (CLIPSYD - EA4430), University of Paris Nanterre, Paris, France
| | - Kristien Michielsen
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Joseph D Tucker
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, USA
| | - Linda Campbell
- Centre for Population, Family and Health, University of Antwerp, Antwerp, Belgium
| | - Claus Vögele
- Research Group Self-Regulation and Health, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Fischer VJ, Andersson G, Billieux J, Vögele C. The Relationship Between Emotion Regulation and Sexual Function and Satisfaction: A Scoping Review. Sex Med Rev 2022; 10:195-208. [PMID: 35012894 DOI: 10.1016/j.sxmr.2021.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Sexual problems are characterized by difficulties in the ability to respond sexually or to obtain sexual pleasure. Their etiology is assumed to be multifactorial, demanding a biopsychosocial treatment approach. Positive sexual experiences involve the dynamic interplay between cognitive, emotional, and motivational factors. Difficulties in emotion identification or impairment in emotion regulation may thus play a pivotal role in the development and maintenance of sexual problems. OBJECTIVES To conduct a scoping review of the literature on the effects of emotion regulation on sexual function and satisfaction. METHODS We conducted a scoping review using Cinahl, Lilacs, Scielo, Scopus, PsycInfo and Pubmed electronic databases using search terms related to emotion regulation and sexual function and satisfaction. RESULTS 27 articles met the inclusion criteria and were further analyzed. Overall, emotion regulation difficulties were associated with poorer sexual health outcomes, difficulties in the sexual response cycle and overall lower sexual satisfaction. Laboratory studies and intervention trials found positive effects of promoting emotion regulation change on sexual function and satisfaction. CONCLUSIONS Despite the methodological diversity of studies, it can be concluded from this review that difficulties in emotion regulation are related to sexual difficulties and sexual dissatisfaction. Future research should consider emotion regulation-focused interventions to mitigate sexual health problems.. Fischer VJ, Andersson G, Billieux J, et al. The Relationship Between Emotion Regulation and Sexual Function and Satisfaction: A Scoping Review. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
- Vinicius Jobim Fischer
- Department of Behavioral and Cognitive Sciences, University of Luxembourg, Campus Belval, Maison des Sciences Humaines, Esch-sur-Alzette, Luxembourg.
| | - Gerhard Andersson
- Department of Behavioral Sciences and Learning (IBL), Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Joël Billieux
- Cognitive and Affective Regulation Lab (CARLA), Institute of Psychology, University of Lausanne, Quartier UNIL-Mouline, Bâtiment Géopolis, Lausanne, Switzerland
| | - Claus Vögele
- Department of Behavioral and Cognitive Sciences, University of Luxembourg, Campus Belval, Maison des Sciences Humaines, Esch-sur-Alzette, Luxembourg
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Fischer VJ, Andersson G, Billieux J, Vögele C. A randomized controlled trial of an Internet-based emotion regulation intervention for sexual health: study protocol. Trials 2021; 22:706. [PMID: 34654460 PMCID: PMC8518194 DOI: 10.1186/s13063-021-05586-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 09/01/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction Emotion regulation difficulties have been associated with mental disorders and sexual dysfunctions. Traditional face-to-face transdiagnostic emotion regulation interventions have shown positive results for emotional and personality disorders. Only recently have the effects of these interventions on sexual health started to be investigated. Internet-delivered psychological interventions have several advantages over face-to-face interventions, such as cost-effectiveness, accessibility, and suitability for people who experience shame because of their stigmatized problematic behaviors and those who avoid seeking help. The aims of the SHER 2—TREpS (Portuguese acronym for Emotion Regulation training for sexual health) project are as follows: (a) determine the efficacy of an Internet-based emotion regulation intervention for sexual health and sexual satisfaction and (b) explore the effects of the intervention on (1) emotion regulation skills, (2) mental health, and (3) sexual self-perception. Methods and analysis The study will use a randomized controlled trial design. Eligible participants will be randomly allocated to one of two groups: intervention (Internet-based emotion regulation training) or waitlist control. Assessments will take place before the start of the trial, at the end of the trial, and at 6-month follow up, after which participants assigned to the waitlist control condition will receive the same intervention. Primary outcomes include sexual function and satisfaction and secondary outcomes self-report measures of depression, anxiety, difficulties in emotion regulation, and sexual self-perception. This intervention study is financed by the Luxembourg National Research Fund (FNS). Ethics and dissemination Ethics approval was obtained from the Ethics Review Panel of the University of Luxembourg. Findings will be disseminated via peer-reviewed publications and conference presentations.
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Affiliation(s)
- Vinicius Jobim Fischer
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg - Campus Belval, 11, Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg, Sweden.
| | - Gerhard Andersson
- Department of Behavioural Science and Learning, Department of Biomedical and Clinical Sciences, Linköping University, SE-581 83, Linköping, Sweden
| | - Joël Billieux
- Cognitive and Affective Regulation Lab (CARLA), Institute of Psychology, University of Lausanne, uartier UNIL-Mouline - Bâtiment Géopolis - Bureau 4240, CH-1015, Lausanne, Switzerland
| | - Claus Vögele
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg - Campus Belval, 11, Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg, Sweden
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Fischer VJ, Morris J, Martines J. Developmental screening tools: feasibility of use at primary healthcare level in low- and middle-income settings. J Health Popul Nutr 2014; 32:314-326. [PMID: 25076668 PMCID: PMC4216967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
An estimated 150 million children have a disability. Early identification of developmental disabilities is a high priority for the World Health Organization to allow action to reduce impairments through Gap Action Program on mental health. The study identified the feasibility of using the developmental screening and monitoring tools for children aged 0-3 year(s) by non-specialist primary healthcare providers in low-resource settings. A systematic review of the literature was conducted to identify the tools, assess their psychometric properties, and feasibility of use in low- and middle-income countries (LMICs). Key indicators to examine feasibility in LMICs were derived from a consultation with 23 international experts. We identified 426 studies from which 14 tools used in LMICs were extracted for further examination. Three tools reported adequate psychometric properties and met most of the feasibility criteria. Three tools appear promising for use in identifying and monitoring young children with disabilities at primary healthcare level in LMICs. Further research and development are needed to optimize these tools.
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