Psychological Treatment of Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia Using an Integrative Approach

Persistent genital arousal disorder/genitopelvic dysesthesia (PGAD/GPD) is characterized by persistent, unwanted physiological genital arousal (i.e., sensitivity, fullness, and/or swelling) in the absence of sexual excitement or desire which can persist for hours to days and causes significant impairment in psychosocial well-being (e.g., distress) and daily functioning. The etiology and course of PGAD/GPD is still relatively unknown and, unsurprisingly, there are not yet clear evidence-based treatment recommendations for those suffering from PGAD/GPD. We present the case of a 58-year-old woman with acquired persistent genital arousal disorder, which began in March 2020; she believed she developed PGAD/GPD due to a period of significant distress and anxiety related to the COVID-19 pandemic. After seeking medical diagnosis and treatment from multiple healthcare providers and trying a combination of pharmacological and medical treatment modalities, she presented for psychological treatment. An integrative therapy approach (3 assessment sessions, 11 treatment sessions), which included cognitive behavior therapy, distress tolerance and emotion regulation skills from dialectical behavior therapy, and mindfulness practice, was utilized. The patient reported improvements anecdotally (e.g., decreased impact on occupational and social functioning, greater self-compassion, less frequent and shorter duration of PGAD/GPD flare-ups, improved ability to cope with PGAD/GPD symptoms, and decreased need for sleeping medication) and on self-report measures (e.g., lower PGAD/GPD catastrophizing, lower anxiety and depression, and greater overall quality of life).We report the use of an integrative (i.e., psychoeducational, cognitive behavioral, dialectical behavioral, and mindfulness-based) intervention, which may be an effective psychological treatment for PGAD/GPD.

Few Differences in Sexual Talk by Gender/Sex and Dyad Type: A Retrospective and Daily Diary Study with Couples

Sexual talk is a type of verbal communication that occurs exclusively during sexual activity and that is specific to the sexual activity itself. Previous research has identified two types of sexual talk: individualistic (i.e., self-focused) and mutualistic (i.e., sharing/partner-focused), which have generally been linked to greater sexual and relationship well-being. Whether sexual talk use varies by gender/sex (i.e., men, women, gender/sex diverse individuals; GSD) or dyad type (i.e., same- vs. mixed-gender/sex) has not been examined. Given initial evidence that the types of sexual talk may contribute differently to sexual and relationship well-being, it is important to identify factors (e.g., gender/sex) that may be associated with the amount of sexual talk used. We examined differences by gender/sex and dyad type in the average sexual talk use among long-term couples (N = 229; 69 same-gender/sex) using retrospective cross-sectional dyadic data. We also examined these differences in the same sample (N = 217) using a 35-day dyadic daily diary study. Retrospectively, but not daily, women reported using more mutualistic talk than men, especially when partnered with a woman. There were no significant gender/sex or dyad type differences in use of individualistic talk retrospectively or daily. Exploratory analyses with the GSD couples suggested that there may be gender/sex and dyad type differences retrospectively and daily, for individualistic and not mutualistic talk; however, these analyses must be interpreted with caution due to the small subsample size of GSD couples.

Socially prescribed perfectionism predicts next-day binge eating behaviors over 20-days

Existing research on perfectionism and binge eating suggests that socially prescribed, self-oriented, and other-oriented perfectionism (Socially Prescribed Perfectionism, SPP; Self-Oriented Perfectionism, SOP; and Other-Oriented Perfectionism, OOP) are differentially related to binge eating. However, previous studies have largely utilized cross-sectional methodology. The present study used a 20-day daily diary methodology to examine associations between daily levels of perfectionistic dimensions and next-day binge eating behaviors with a nonclinical sample of emerging adults (N = 263). Zero-inflated negative binomial regression models indicated that daily SPP (but not SOP or OOP) predicted a greater intensity of next-day binge eating behaviors in the count portion of the model; however, daily levels of perfectionistic dimensions did not predict the presence/absence of next-day binge eating behaviors in the zero-inflated portion of the model. Additionally, analyses examining the reverse causal direction (i.e., binge eating behaviors predicting higher next-day perfectionism) failed to provide evidence that the occurrence or intensity of binge eating behaviors predicts next-day levels of SPP, SOP, or OOP. Overall, at a daily level, SPP appears to be a vulnerability factor for binge eating behaviors. It may be helpful for clinicians to target state-levels of SPP to reduce harmful binge eating behaviors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Perceived Partner Responsiveness Moderates the Associations Between Sexual Talk and Sexual and Relationship Well-Being in Individuals in Long-Term Relationships

Sexual communication promotes sexual and relationship well-being. Previous research has frequently neglected couples' communication that occurs exclusively during sexual activity, and that is specific to that sexual interaction (i.e., sexual talk). We examined associations between individualistic and mutualistic (i.e., self- and other-focused) sexual talk and sexual and relationship well-being, and the potential moderating role of perceived partner responsiveness to sexual talk (PPR). An MTurk community sample of 303 individuals (171 female) in committed relationships completed online measures assessing sexual satisfaction, sexual functioning, sexual distress, relationship satisfaction, sexual talk, and PPR. Greater mutualistic talk was associated with higher female sexual functioning, whereas greater individualistic talk was associated with lower relationship satisfaction. At higher levels of PPR, using more mutualistic talk was associated with less sexual distress and more individualistic talk was associated with greater sexual satisfaction. At lower levels of PPR, more mutualistic talk was associated with more sexual distress and more individualistic talk was linked to poorer sexual satisfaction. PPR may help buffer against the negative associations between self-focused (i.e., individualistic) sexual talk and sexual and relationship well-being, whereas other-focused (i.e., mutualistic) sexual talk may be beneficial for sexual and relationship well-being, unless a partner is perceived as very unresponsive.

We Need to Talk: Disclosure of Sexual Problems Is Associated With Depression, Sexual Functioning, and Relationship Satisfaction in Women

Women with sexual problems (e.g., difficulties with desire, arousal, lubrication, orgasm, and pain during sexual activity) experience more depressive symptoms, and poorer sexual functioning and relationship satisfaction compared with unaffected women. A robust literature highlights the importance of sexual communication, and sexual self-disclosures in particular, for the well-being of individuals in romantic relationships. However, little is known about the disclosure of sexual problems to romantic partners and its association with women's psychological, sexual, and relationship well-being. This study examined the proportion of women (N = 277) who disclose (vs. do not disclose) sexual problems to their partner, and the consequences of disclosure. Women (M_age = 29.79, SD = 6.54) completed online validated measures assessing sexual problems, relationship satisfaction, sexual functioning, and depressive symptoms. The majority (69.3%) reported disclosing sexual problems to their current romantic partner. Disclosers reported fewer depressive symptoms, and greater sexual functioning and relationship satisfaction compared to nondisclosers. Disclosing sexual problems may benefit women's well-being by enhancing intimacy or allowing couples to adapt sexual activities to accommodate sexual problems. Clinicians might use cognitive-behavioral strategies to assist women in disclosing sexual problems to partners to maximize the potential psychological, sexual, and relationship benefits.