A Dyadic Perspective on Childhood Maltreatment for Women With Provoked Vestibulodynia and Their Partners: Associations With Pain and Sexual and Psychosocial Functioning

Childhood maltreatment is robustly associated with adult-onset vulvodynia, a common form of female genito-pelvic pain/penetration disorder. However, little is known about the impact of childhood maltreatment on current sexual, psychological, and relationship adaptation for couples with provoked vestibulodynia (PVD). This study examined the associations between childhood maltreatment and sexual and psychosocial functioning and pain in women with PVD, the most common subtype of vulvodynia, and their partners. A total of 49 couples (M_age women = 27.80, SD = 6.05; M_age men = 30.04; SD = 6.48) with PVD completed the Childhood Trauma Questionnaire (CTQ), as well as measures of sexual functioning, couple satisfaction, and anxiety. Women also reported on their pain during intercourse. Analyses were guided by the actor–partner interdependence model. Women’s higher reports of childhood maltreatment were associated with their lower sexual functioning and higher anxiety. Partners’ higher reports of childhood maltreatment were associated with their lower sexual functioning, lower couple satisfaction, and higher anxiety, as well as women’s lower couple satisfaction and higher anxiety. Both women’s and partners’ higher reports of childhood maltreatment were associated with higher affective pain for women. Findings suggest childhood maltreatment experienced by women with PVD and their partners should be considered as part of treatment planning.     

The Relationship Between Sexual Concordance and Orgasm Consistency in Women

Sexual concordance (the relationship between genital and self-reported sexual responses) may be associated with orgasm consistency (OC; the proportion of sexual acts leading to orgasm) during penile–vaginal intercourse (PVI) in women. We investigated the relationship between women’s sexual concordance (assessed using different stimulus modalities and self-reported sexual arousal methods) and OC during various sexual activities (assessed using different types of questions). For Study 1 (n = 51), when sexual concordance was assessed using audiovisual sexual stimuli, we did not find a statistically significant relationship between OC and poststimulus self-reports of sexual arousal or genital sensations, raw values of OC, or ranges of OC. For Study 2 (n = 44), where sexual concordance was assessed using audionarrative sexual stimuli, we did find a statistically significant relationship between PVI OC and sexual concordance using change in self-reported sexual arousal, and ranges of orgasm consistency. Two findings were inconsistent with previous research. First, OC varied significantly by activity type in both studies; masturbation yielded the highest OC. Second, PVI OC was significantly related to oral sex and masturbation OC (Study 2). We discuss the need for further research and various factors that may affect women’s orgasm consistency and sexual concordance.     

The Effects of Target Attractiveness on Men's Sexual Arousal in Response to Erotic Auditory Stimuli

Previous research on sexual arousal resulting from auditory stimuli indicates that visual imagery acts as a mediator between stimulus input and resulting arousal. This leads to the question of whether imagery, and subsequent arousal, can be manipulated by providing differing information to hold in semantic memory. This research hypothesizes that attractive images, held within semantic memory and pattern matched with an erotic auditory stimulus, facilitate higher and more rapid self-reported arousal than do unattractive images. Participants in an unattractive condition experienced slower rates and lower mean levels of arousal in response to an auditory stimulus compared with participants in an attractive or no picture condition. No differences existed between groups in maximum arousal scores or the tendency to visualize the target during the listening task. Implications for the role of imagery in sexual response, possible measurement issues, and suggestions for future research are addressed in the discussion.     

Observational Stance as a Predictor of Subjective and Genital Sexual Arousal in Men and Women

Observational stance refers to the perspective a person takes while viewing a sexual stimulus, either as a passive observer (observer stance) or an active participant (participant stance). The objective of the current study was to examine the relationship between observational stance and sexual arousal (subjective and genital) across a range of sexual stimuli that do or do not correspond with a participant's sexual attraction (preferred or nonpreferred stimuli, respectively). Regression analyses revealed that, for men (n = 44), participant stance significantly predicted subjective and genital arousal. Women's (n = 47) observer and participant stance predicted subjective arousal but not genital arousal. Analysis of variance showed that participant stance was greatest under preferred sexual stimuli conditions for all groups of participants, while observer stance scores revealed a less consistent pattern of response. This was particularly true for opposite-sex-attracted women, whose ratings of observer stance were lowest for preferred stimuli. Observational stance does not appear to account for gender differences in specificity of sexual arousal; for men, however, participant stance uniquely predicted genital response after controlling for sexual attractions. Similarities in the relationships between men's and women's observational stance and sexual responses challenge previous claims of gender differences in how men and women view erotica.     

Using the Dual Control Model to Investigate the Relationship Between Mood,Genital, and Self-Reported Sexual Arousal in Men and Women

Recent findings suggest that there is considerable interindividual variability in how mood affects sexual arousal and that the dual control model may be helpful in explaining this variation. The current research investigated whether mood interacted with sexual excitation and inhibition proneness to predict subjective and genital arousal. In this study, 33 participants (18 men; 15 women), ages 18 to 45, attended three laboratory sessions where they completed questionnaires assessing preexisting mood and propensity for sexual excitation and inhibition, then watched a series of neutral and sexually explicit films. Subjective sexual arousal was continuously indicated during each film, while genital temperature was measured using thermographic imaging. Sexual excitation and inhibition interacted with various mood scores to significantly predict both subjective and genital arousal in men and women. Several gender differences were found. For example, vigor scores interacted with sexual excitation proneness to significantly predict genital but not subjective arousal in women, while the same interaction significantly predicted subjective but not genital arousal in men. The findings supported the hypothesis that the dual control model is an important framework in understanding how mood influences both subjective and genital sexual arousal.     

Changes in Sexual Distress,Depression and Sexual Function after Clitoral Reconstruction in Women with Female Genital Mutilation/Cutting

Abstract

Background: Female genital mutilation/cutting (FGM/C) links health complications and psychological distress. However, there is scarce literature on how women with FGM/C respond to treatment interventions. Objective: In this study, we aimed to assess changes in depression symptomatology, sexual function, and distress following clitoral reconstructive surgery combined with a psychoeducational intervention. Methods: The reconstructive surgery consisted of recovering the remaining clitoris and placing it externally and as close to the vagina as possible. FGM/C patients (n?=?27) received psychological support and sexual counseling upon undergoing the surgical intervention and were further assessed at 6-month follow-up. Moreover, they completed the Beck Depression Inventory and the Female Sexual Distress Scale Revised at these two time points. Patients’ sexual dysfunction was assessed according to DSM-5 criteria. Results: Statistically significant clinical changes after FGM/C were reported. Overall, patients presented reduced depression and sexual distress levels, and decreased female sexual interest/arousal disorder prevalence. Results also revealed that sexual distress improvements were more significant in Type I FGM/C patients. Conclusions: Significant improvements in sexual distress, psychopathology, and sexual function were observed in our sample following reconstructive surgery, suggesting that combined interventions are effective for treatment.     

The Impacts of Sexual Arousal and Its Suppression on Executive Functioning

Suppression of certain types of reflexive emotional responses is thought to temporarily deplete executive functions (EF), as evidenced by poorer performance on measures of EF, but does not deplete other, lower-order cognitive processes. This study examined whether similar decrements in performance on EF tests would occur following suppression of sexual arousal. A sample of 44 male college students underwent baseline cognitive assessment (EF and lower-order cognitive processes), followed by experimental manipulation consisting of exposure to sexually explicit audiovisual stimuli. Sexual arousal was monitored using penile plethysmography. In this study, 21 participants were assigned to a suppression condition and were instructed to suppress sexual arousal during the video, while 23 were assigned to an arousal condition and were instructed to allow themselves to become aroused. Following experimental manipulation, cognition was reassessed. Unexpectedly, results showed EF decrements in the arousal group but not in the suppression group. As expected, only EF was affected by experimental manipulation, with no group differences in lower-order cognitive processes. Thus, the findings suggest that sexual arousal is associated with temporary decrements in EF performance, at least among young, primarily White, male college students. The results contribute to understanding why sexually charged situations are sometimes associated with poor decisions or unsafe/reckless sexual practices.     

Affective and Autonomic Responses to Erotic Images: Evidence of Disgust-Based Mechanisms in Female Sexual Interest/Arousal Disorder

Disgust has recently been implicated in the development and maintenance of female sexual dysfunction, yet most empirical studies have been conducted with a sexually healthy sample. The current study contributes to the literature by expanding the application of a disgust model of sexual functioning to a clinically relevant sample of women with low sexual desire/arousal and accompanying sexual distress. Young women (mean age = 19.12 years) with psychometrically defined sexual dysfunction (i.e., female sexual interest/arousal disorder [FSIAD] group) and a healthy control group were compared in their affective (i.e., facial electromyography [EMG] and self-report) and autonomic (i.e., heart rate and electrodermal activity) responses to disgusting, erotic, positive, and neutral images. Significant differences were predicted in responses to erotic images only. Specifically, it was hypothesized that the FSIAD group would display affective and autonomic responses consistent with a disgust response, while responses from the control group would align with a general appetitive response. Results largely supported study hypotheses. The FSIAD group displayed significantly greater negative facial affect, reported more subjective disgust, and recorded greater heart rate deceleration than the control group in response to erotic stimuli. Greater subjective disgust response corresponded with more sexual avoidance behavior. Planned follow-up analyses explored correlates of subjective disgust responses.     

Sexual Well-Being in Older Women: The Relevance of Sexual Excitation and Sexual Inhibition

The aim of this study was to use the dual control model of sexual response (DCM) to investigate variation in sexual well-being among women 50 years of age and older. Data from 185 women 50 years of age and older (M = 59.46, SD = 6.96) were used to examine the relationships between sexual excitation (SE) and sexual inhibition (SI) and their lower-order factors to indicators of sexual well-being (i.e., sexual functioning, satisfaction, distress, frequency of sexual activity, and breadth of sexual behavior). Possible moderating factors were also explored. Independently, SE and SI were associated with the majority of the indicators of sexual well-being, and the directions of associations were consistent with the tenets of the DCM. SE and SI lower-order factors were significant predictors of sexual function, satisfaction, and frequency of sexual activity. Sexual distress was predicted more strongly by SI factors and breadth of sexual behavior by one SE lower-order factor (arousability). Partner physical and mental health and participant’s own mental health were identified as moderating variables of these associations. Findings of this study are discussed considering the contribution of the DCM to understanding the role of diversity in older women’s sexual well-being.     

Sexual Risk-Taking among High-Risk Urban Women with and without Histories of Childhood Sexual Abuse: Mediating Effects of Contextual Factors

This study investigated the mechanisms of risk for urban women at high risk for HIV with and without childhood sexual abuse histories. Childhood sexual abuse survivors reported more unprotected intercourse and sexually transmitted infections (STIs). The association of STI locus of control with frequency of unprotected sex was fully mediated by being intoxicated during sex and engaging in sex work, whereas the association between relational control and unprotected sex was not mediated by contextual factors for the childhood sexual abuse group. The mechanisms of risk are different for those with divergent childhood sexual abuse histories and thus interventions should be developed to educate women with a history of childhood sexual abuse about ways to avoid revictimization, particularly within a context of poverty, prostitution, and drug use.     

Relationship Between Childhood Sexual Abuse and Borderline Personality Disorder in Women Psychiatric Inpatients

The rclationshp between childhood sexual abuse (CSA) and borderline personality disorder (BPD) in 50 women psychiauic inpatients was examined. Inpatienfs were inletviewed using he Diagnostic Interview for Borderlines (Revised) (DIB-R). Women sexually abused as children (n = 30) scored significantly higher than those who were not (n = 20) on the total DIB-R and three of its four section scores. Women sexually abused as children were significantly more likely to have a definite diagnosis of BPD than women not sexually abused as children. who largely exhibited symptom patterns indicative of diagnoses other than BPD. An unexpected finding was that women sexually abused as children were more likely to have eating disorders than those who were not. Treatment for borderlines should explicilly address and validate the tremendous consequences of CSA on etiology and course of symptoms.     

Effects of Genital Response Measurement Device and Stimulus Characteristics on Sexual Concordance in Women

Investigations of sexual concordance suggest that, on average, women exhibit a low, positive correlation between their subjective sexual arousal and genital response. However, this relationship appears to be stronger, on average, when genital response is measured via the external tissues of the vulva than within the vagina walls. Given the methodological variations, such as stimulus content and duration, in studies of vulvar and vaginal concordance, direct comparisons between individual studies are limited. In the current study, sexual concordance was examined using concurrent measures of vulvar blood flow (using laser Doppler imaging) and vaginal vasocongestion (using vaginal photoplethysmography) to investigate potential differences in vulvar and vaginal concordance. Twenty-five women viewed two erotic films that differed in sexual activity content (foreplay and intercourse) while their subjective sexual arousal and genital response was measured. In support of previous meta-analytic findings, results suggest that subjective sexual arousal is more strongly correlated with vulvar blood flow than with vaginal vasocongestion. Likewise, perceived genital response and actual vulvar blood flow are more strongly related than are vaginal vasocongestion and self-reported genital sensations. Practical implications for the study of women’s sexual concordance as well as broader implications for the understanding of female sexuality are considered.     

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.     

Emergence of Nonsexual Crimes and Their Relationship to Sexual Crime Characteristics and the Deviant Arousal of Male Adolescent Sexual Offenders: An Exploratory Study

In this study, we explore nonsexual crimes committed by a sample of 437 incarcerated adolescent sexual offenders as well as deviant arousal and its relationships to nonsexual and sexual crimes. Over 50% of the juvenile sexual offenders in this sample have committed nonsexual offenses. In addition, nonsexual crimes, particularly general delinquency, were significantly correlated to a number of characteristics of sexual crimes committed by the youth. Previous research has shown that sexually abusive youth are more likely to recidivate nonsexual crimes, and among the implications of this study is the need for treatment providers and service delivery systems to address nonsexual as well as sexual crimes.     

Predictors and Moderators of Sexually Related Distress in Women with Persistent Genital Arousal Disorder

Abstract

The degree of general distress reported by women with Persistent Genital Arousal Disorder (PGAD) varies greatly, which might relate to their level of anxiety or depression. A variety of medical problems also has been associated with PGAD symptoms. The current study sought to determine the most significant predictor of sexually related distress and examine possible moderators. Participants were 51 women who met the criteria for PGAD and completed an online survey. Hierarchical regression determined depression significantly predicted sexually related distress, but anxiety and stress measures did not. Erotophobia and perceived partner support did not moderate the relationship between depression and sexually related distress. Greater numbers of concomitant medical diagnoses were significantly correlated with sexually related distress. The results indicate that PGAD is experienced by women as sexually distressing. As we continue to learn more about PGAD, a biopsychosocial treatment approach to PGAD, including psychotherapy would seem warranted.     

The Relationship between Social Dominance Orientation and Child Sexual Abuse Credibility Assessment

ABSTRACT

Allegations of child sexual abuse (CSA) across various contexts have often been denied or ignored by a multitude of people, including those who do not personally know the alleged perpetrators or victims. The lack of belief of children’s CSA reports is problematic, as this may affect the child’s adjustment, the consequences for the alleged perpetrator, and the likelihood of other victims reporting abuse that they experienced. One plausible explanation for low credibility is the variable of social dominance orientation. In the current study, a diverse sample (N = 60) read a hypothetical vignette of a CSA allegation, rated the credibility of the child, and completed the Social Dominance Orientation-7 scale (SDO-7). Results supported that high social dominance orientation predicts low credibility ratings of the child’s CSA allegation. Findings may impact how clinicians and investigators approach the assessment of credibility of CSA allegations, how they appraise the opinions of others about such credibility, and jury selection in the court system.     

Childhood Maltreatment and Difficulties in Emotion Regulation: Associations with Sexual and Relationship Satisfaction among Young Adult Women

This study examined relations among childhood maltreatment, difficulties in emotion regulation, and sexual and relationship satisfaction among young adult women reporting current involvement in committed, romantic relationships. A sample of 192 women (ages 18–25) completed self-report questionnaires as part of an Internet-based survey. It was hypothesized that severity of childhood maltreatment and difficulties in emotion regulation would each independently and negatively predict (a) sexual satisfaction, (b) relationship intimacy, and (c) expression of affection within the context of the relationship. Furthermore, it was hypothesized that greater emotion regulation difficulties would moderate the effects of childhood maltreatment on these sexual and relationship variables (i.e., sexual satisfaction, relationship intimacy, and expression of affection). Findings suggest that difficulties in emotion regulation demonstrated an incremental effect with regard to sexual satisfaction, but not with intimacy and affection expression. In contrast to predictions, no significant interactive effects were documented. Clinical implications and future directions related to this line of inquiry are discussed.