When sex isn't the answer: Examining sexual compliance,restraint, and physiological stress

Past research suggests that sexual activity has numerous health benefits; however, we argue that the association between sexual behavior and health is nuanced. More specifically, we argue that when individuals comply with their partner's sexual desire, sex may have unintended negative health consequences. As such, we evaluated how sexual desire and frequency interact to predict individuals' cortisol levels (i.e. a physiological measure of stress) in romantic relationships. Sixty-four participants (38 women, 26 men) who were in generally good health provided salivary cortisol samples and completed questionnaires assessing sexual behavior. As hypothesized, multiple regression analyses confirmed that the interaction between desired and actual sexual frequency predicted cortisol; participants who reported higher sexual frequency than desired (i.e. sexual compliance) had higher cortisol than participants whose desired and actual frequency matched. Interestingly, participants who reported lower frequency than desired (i.e. sexual restraint) had cortisol levels similar to participants whose desired and actual frequency matched. Overall, the results suggest that being sexually compliant (i.e. engaging in more frequent sex than desired) may be stressful and thus lead to negative physiological consequences.     

Personality and sexuality in relation to an index of gonadal steroid hormone balance in a 70-year old population

Relationships between an index of gonadal steroid hormone function and personality as well as sexual activity were studied in a sample representative for 70-year-olds in Gotenburg, Sweden. Personality was described by means of inventories, sexual activity through a systematic interview and the balance between androgen and oestrogen activity by the quotient between lecithin and lysolecithin in plasma. Men with a relative dominance of androgen activity described themselves as more aggressive than other men. Men with a relative dominance of oestrogen activity reported a lower frequency of sexual intercourse than other men. Women with a relative dominance of oestrogen activity described themselves as more resourceful, active, confident, unconcerned with the opinion of others, and able to take care of themselves than other women. There were no associations in women between the hormonal balance and the frequency of sexual intercourse.     

Drug abuse and intimate partner violence: a comparative study of opioid-dependent fathers

Because very little is known about the coparenting relationships of drug-abusing men, this comparative study was designed to examine the lifetime prevalence and recent frequency of intimate partner violence in the coparenting relationships of 106 fathers enrolled in methadone maintenance treatment. When compared with 118 community controls, the opioid-dependent fathers reported greater prevalence of physical, sexual, and psychological aggression directed at the mother of their youngest biological child over the course of the relationship. They also reported more frequent physical, sexual, and psychological aggression directed at the mother during the previous year. Similarly, the opioid-dependent fathers reported both greater prevalence of physical and sexual aggression directed at them by the mother of their youngest child over the course of the relationship and more frequent sexual aggression directed at them over the previous year. The results highlight the need for clinicians to consider risk for intimate partner violence in coparenting relationships when planning family-oriented intervention designed to meet the needs of fathers, mothers, and children affected by chronic drug abuse.     

Challenging Stereotypes: Sexual Functioning of Single Adults with High Functioning Autism Spectrum Disorder

This study examined the sexual functioning of single adults (61 men, 68 women) with high functioning autism and Asperger syndrome living in the community with and without prior relationship experience. Participants completed an on-line questionnaire assessing autism symptoms, psychological functioning, and various aspects of sexual functioning. In general participants reported positive sexual functioning. Participants without prior relationship experience were significantly younger and more likely to be male and identify as heterosexual. They reported significantly higher sexual anxiety, lower sexual arousability, lower dyadic desire, and fewer positive sexual cognitions. The men reported better sexual function than did the women in a number of areas. These results counter negative societal perceptions about the sexuality of high functioning individuals on the autism spectrum.     

Violence and PTSD in Mexico

OBJECTIVE: We examined the lifetime prevalence of violence in Mexico and how different characteristics of the violent event effect the probability of meeting criteria for lifetime post-traumatic stress disorder (PTSD). METHOD: We interviewed a probability sample of 2,509 adults from 4 cities in Mexico (Oaxaca, Guadalajara, Hermosillo, Mérida) using the Composite International Diagnostic Interview (CIDI). RESULTS: Lifetime prevalence of violence was 34%. Men reported more single-experience, recurrent, physical, adolescent, adulthood, and stranger violence; women more sexual, childhood, family, and intimate partner violence. Prevalence was generally higher in Guadalajara, though the impact was greater in Oaxaca compared to other cities. Of those exposed, 11.5% met DSM-IV criteria for PTSD. Probabilities were highest after sexual and intimate partner violence, higher for women than men, and higher in Oaxaca than other cities. CONCLUSIONS: It is important to consider the characteristics and the context of violence in order to develop effective prevention and intervention programs to reduce the exposure to and impact of violence.     

Pacific Islands families study: intimate partner stressors and psychological distress among pacific adults

Although there has been increased research about the nature and predictors of sexual problems, relatively little is known about sexual health and well-being among minority ethnic groups across the world. This study explored stressful intimate relationship events that made a significant impact on psychological distress among Pacific adults living in New Zealand. The Pacific Islands Families (PIF) study is a longitudinal investigation of Pacific children born in New Zealand, and their parents. The 12-item General Health Questionnaire (GHQ12) and intimate partner stress items were used to assess the relationship between these stressful events and psychological distress among Pacific mothers and fathers (n = 3963 interviews with 2114 individuals). For both men and women, the most significant partner stress associated with psychological distress was problems with sex. These findings show how stressful events around sexuality and intimate relationships affect Pacific psychological well-being. These intimate issues need to be considered when designing intervention and treatment programmes that are adaptive for long-term family stability and sexual well-being. The relationship between culture, sexuality, and psychological distress needs further investigation. Using a qualitative methodology would provide a more intensive exploration of the role that cultural context plays in intimate relationships and sexuality in Pacific adults.     

Sexual problems in two inner city London sexual health centres: prevalence,attributions and need for psychosexual services

Sexual problems are common and psychosexual provision is recommended within sexual health services. This study aimed to explore and compare the prevalence and range of sexual problems in men and women attending two sexual health centres; explore patients' attributions for sexual problems; and establish the need for psychosexual clinics. Questionnaires were completed by 868 patients (452 men; 416 women) attending two sexual health centres in London, UK. Women reported more sexual problems than men overall (43 and 32%, respectively). Thirteen percent of men and 18% of women reported reduced interest in sex, 16% of men and 11% of women had arousal difficulties, 6% of men and 18% of women experienced painful sex and 19% of men and 24% of women reported ejaculation/orgasm problems. The majority of sexual problems interfered with patients' lives. Most sexual problems had started within the last year. However, ejaculation/orgasm problems had typically been experienced for longer. Men and women most commonly attributed their sexual problems to an emotional cause. Only a minority of patients with sexual problems were receiving help despite almost half of patients wanting it. Increased identification and treatment for sexual problems is essential in sexual health services.     

Sex education: The challenge for the educators

This study examined the association between unwanted early sexual experiences (UESE) and sexual adjustment among 2,608 Belgian students (men = 1,017; women = 1,587) and 1,081 South African students (men = 335; women = 739) and the severity of the experience in its bothersomeness. Of Belgian women, 14.2% (226) reported UESE compared to 31.3% (231) of South African women; and of Belgian men 12.3% (125) indicated that they had an UESE compared to 56.4% (189) of South African men. Against expectations, those without UESE showed significant poorer sexual adjustment. The severity of UESE was also associated with greater bothersomeness by all respondents except for Belgian men at the time of completing the checklist. However, no association was found between severity and bothersomeness at the time of UESE.     

The behavioral and cognitive-behavioral treatment of female sexual dysfunction: how far we have come and the path left to go

Over the past several decades, researchers have been trying to determine efficacious treatments for sexual dysfunctions. While sexual dysfunction is problematic for both men and women, studies have shown women consistently deal with it at higher rates than men. Proposed treatment modalities come in many forms, yet many outcome studies support the use of behavioral or cognitive-behavioral interventions when addressing female sexual dysfunction. This paper will review the prevalence of female sexual dysfunction, provide a brief history of its treatment, and outline studies that used behavioral and cognitive-behavioral treatments. Lastly, a discussion will address the need for psychologists to continue researching, improving and promoting the use of psychological interventions for women who present with concerns related to sexual functioning.     

Relationship of childhood physical and sexual abuse to adult bipolar disorder

Objectives: To characterize whether adult depressives with either bipolar or unipolar disorder differ in the prevalence of childhood sexual or physical abuse.

Method: The investigators reviewed data from patients who were evaluated over a 2-year period by a semi-structured clinical interview. In total, 333 cases with a bipolar or unipolar diagnosis were included in the present study.

Results: A childhood history of abuse, in particular sexual abuse, was significantly more frequent in bipolar subjects compared with unipolar subjects. Consistent with previous studies, women reported higher rates of sexual abuse than men, although no interaction by diagnosis was shown. Sexual abuse incidence in male samples was markedly dissimilar, with male bipolar subjects demonstrating a significantly increased rate of sexual abuse and combined sexual and physical abuse compared with unipolar male subjects.

Conclusion: The increased incidence of sexual abuse in women supports growing evidence of gender differences in sexual abuse among adult depressives. In contrast to literature reports, the finding that male bipolar patients have significantly increased rates of sexual abuse histories suggests differences in psychiatric depressive subgroups. This result may reflect the particular characteristics of our cohort (treatment resistant, privately insured, and educated). Further work will aid in characterizing sexual abuse prevalence in other male bipolar samples.     

Implications of sexual fantasy characteristics and memory intensity for harmful sexual behaviour

Background

Sexual fantasies and memories are aetiological considerations in the perpetration of sexual violence, but fantasy–memory–behaviour relationships may be influenced by various factors, including sexual fantasy and memory phenomenology, that are the properties of mental imagery.

Aims

To investigate differences in sexual fantasy phenomenology and sexual memory intensity in men who report a history of harmful sexual behaviour compared to those who do not. We also investigated whether the likelihood of reporting harmful sexual intent was related to sexual memory intensity, independently of age and harmful sexual behaviour history.

Methods

An online cross-sectional survey design was used, focusing on men aged ≥18 years who were recruited from the general population via social media. The survey prompted participants to envisage a favoured sexual fantasy, then obtained data on fantasy phenomenology, including vividness and sensations, and arousal level. In addition, information was requested about sexual memory intensity and harmful sexual behaviour history and intent.

Results

A total of 322 men completed the survey. Multiple Welch's t-tests showed that men self-reporting one or more harmful sexual behaviours, such as rape or child sexual abuse, gave significantly higher ratings of sexual fantasy phenomenology but not fantasy frequency or masturbation. They were also more likely to report higher sexual memory intensity. Although the significance of fantasy phenomenology varied between subgroups, binary logistic regression indicated that age, history of harmful sexual behaviour and sexual memory intensity were each independently associated with harmful sexual intent.

Conclusions

Our findings provide new insights into the importance of fantasy phenomenology, demonstrating nuanced differences between those with and without a history of harmful sexual behaviour and illustrating that memory intensity is associated with harmful sexual behaviour intent. Further research into these differences in the context of assessment and intervention for sexual violence perpetration is warranted.

     

Sexual coercion and abuse among women with a severe mental illness in India: an exploratory investigation

Research from the west indicates that women living with a psychiatric disorder are particularly vulnerable to sexual coercion and abuse. However, there have been no published reports of sexual abuse among female psychiatric patients in India. This exploratory study sought (1) to determine the prevalence of sexual coercion in a representative sample of female psychiatric patients in India; (2) to identify clinical and sociodemographic correlates of sexual coercion; (3) to clarify the association between sexual coercion and human immunodeficiency virus (HIV)-related risk behavior; and (4) to determine whether self-report of sexual coercion from these patients was recorded in their medical charts. Consecutive female inpatient admissions (N = 146) to a large psychiatric hospital in southern India were assessed using a structured interview and standardized measures. During these structured clinical interviews, sexual coercion was reported by 30% of the 146 women. The most commonly reported experience was sexual intercourse involving threatened or actual physical force (reported by 14% of women), and the most commonly identified perpetrator was the woman's husband or intimate partner (15%), or a person in a position of authority in their community (10%). Women with a history of abuse were more likely to report HIV-related sexual behavior (P <.001). In contrast to the 30% of women who reported sexual coercion during interviews, only 3.5% of the medical records contained this information. Thus, sexual coercion is a serious and prevalent concern among female Indian psychiatric patients, but is rarely reported in medical charts. Increased screening and reporting are indicated, as are sexual abuse prevention and treatment programs.     

Reduced sexual desire in a random sample of Norwegian couples

Abstract

The purpose of this study was to analyse reduced sexual desire in Norwegian heterosexual couples and to identify factors associated with loss of sexual desire in both men and women. The study comprises a sample of 399 couples (798 individuals) between 22 to 67 years of age. Data were collected by the means of self-administered postal questionnaires. The majority of the couples (59%) did not report distressing problems related to loss of sexual desire. In 26% of the couples the female partner had experienced distressing loss of sexual desire; in 8% of the couples the male partner did, and in 8% of the couples both experienced distressing problems. Most of the men and women who had sexual desire problems believed their loss of sexual desire was related to stress, disease, or “other” factors. Reduced capacity for sexual arousal was the best predictor of loss of desire in both genders. Among women, negative work-to-home interference was related to loss of sexual desire. It seems reduced sexual desire may represent a new area of public health concern in Norway.     

Posttraumatic stress disorder, dissociation, and sexual abuse history in epileptic and nonepileptic seizure patients

Rates of posttraumatic stress disorder (PTSD), dissociative symptoms, and childhood sexual abuse (CSA) are believed to be higher among patients with nonepileptic seizures (NES) than those with epileptic seizures (ES). However, women have higher rates of CSA and sexual assault than men. Comparisons of seizure type controlling for gender may produce different results. Data from an opportunity sample of 34 patients with ES and 17 with NES evaluated during or following phase 1 video-EEG monitoring demonstrated that patients with NES had statistically higher rates of PTSD and CSA and higher Dissociative Experiences Scale (DES) scores than patients with ES. No differences were found between women with NES and ES for histories of PTSD or CSA. Mean between-group DES score differences remained. Results indicated that PTSD, dissociation, and CSA may be common among women presenting to a tertiary epilepsy referral center for both ES and NES. Neither a positive history of CSA nor a history of PTSD was evidence against epilepsy.     

Is responsive sexual desire for partnered sex problematic among men? Insights from a two-country study

In contrast to the body of research focusing on female sexual desire, there has been very little research into patterns of male sexual desire. This study addresses this deficiency in the literature by providing empirical answers to the following three questions: (1) is there a pattern of responsive sexual desire – defined as being predominantly receptive to a partner's initiation of sexual activity without initially desiring it – among men? (2) Is this pattern associated with lower levels of sexual health than a more spontaneous pattern of male desire? (3) Are existing clinical observations regarding possible causes of reduced interest in partnered sex useful for understanding the more responsive men's sexual desire? A large online survey about men's sexual interest was conducted in 2011 among 2215 Norwegian and Portuguese men aged 18–75 years (the average age in the sample was 36.5 years). Sociodemographic, health-related, sociosexual and relationship-related information was collected. Three distinct patterns of male sexual desire were observed: decreased (23.6%), responsive (2.5%) and spontaneous (73.9%) desire patterns. Men in the more responsive and spontaneous desire groups significantly differed from participants in the decreased desire group, as they reported significantly higher levels of sexual interest, sexual satisfaction and frequency of sexual intercourse and were less likely to have experienced sexual health difficulties in the past 12 months. Interestingly, participants with more responsive and spontaneous desire patterns were indistinguishable in terms of a number of sociodemographic, health-related, sociosexual and relationship-related variables. The sole predictor of the responsive sexual desire pattern was proneness to relationship-related sexual boredom. Clinical observations about the roles of negative emotions, relationship strain and specific sexual arousal patterns (homoerotic, autoerotic and/or paraphilic) in the etiology of hypoactive sexual desire did not seem relevant for men with responsive desire.     

The Prevalence of Sexual Dysfunction in Male and Female Hypertensive Patients

A questionnaire containing questions on sexual functioning was sent to 800 hypertensive patients. A response rate of 68.3% was obtained. Of these 60 men and 100 women did not have intercourse. 208 men reported on their erectile ability and 201 men reported on their ejaculatory function. The prevalence of erectile inadequacy was age related in the treated patients, and ranged from 27% in 20–39 years to 70% in patients over 60 years. Treatment was associated with a significantly increased prevalence of erectile dysfunction (untreated 26%, treated 55%; P≤0.01). The prevalence of ejaculatory difficulty was age-related only occurring in men over 40 years of age and occurred more frequently in treated (45%) than untreated (14%) patients (P≥0.01). 178 women reported on their ability to become sexually arroused and to attain orgasm. 22% of women reported never having difficulty becoming aroused and 8% reported that they always experienced orgasm. The prevalence of arousal and orgasmic dysfunction was not age or treatment-related     

Sexuality and romantic relationships: investigating the relation between attachment style and sexual satisfaction

Attachment theories have recently been applied to adult romantic relationships, and more specifically, sexuality within these relationships. However, few studies have examined the influence of attachment-related avoidance and anxiety on sexual communication, gender role ideology, sexual satisfaction or the relations between these constructs. Men (n = 106) and women (n = 349) undergraduate students and young adults from the community completed an online questionnaire measuring attachment style, sexual communication, gender role ideology, and sexual satisfaction. Multiple mediation and path analyses showed several interrelations between these variables among women. Additionally, gender role ideology and sexual communication together were found to totally mediate the relation between attachment-related anxiety and sexual satisfaction in women. Sexual communication partially mediated the relation between attachment-related avoidance and sexual satisfaction in women. Among men, the only significant finding was that attachment-related anxiety and avoidance were related to lower sexual communication. These results indicate that there is disparity in sexual communication, gender role ideology, and sexual satisfaction among individuals with differing attachment orientations and that these effects may be more prominent in women than men.     

Childhood abuse and lifetime psychopathology in a community sample.

OBJECTIVE: The authors assessed lifetime psychopathology in a general population sample and compared the rates of five psychiatric disorder categories between those who reported a childhood history of either physical or sexual abuse and those who did not. METHOD: A modified version of the Composite International Diagnostic Interview and a self-completed questionnaire on child abuse were administered to a probability sample (N=7,016) of Ontario residents 15 to 64 years of age. RESULTS: Those reporting a history of childhood physical abuse had significantly higher lifetime rates of anxiety disorders, alcohol abuse/dependence, and antisocial behavior and were more likely to have one or more disorders than were those without such a history. Women, but not men, with a history of physical abuse had significantly higher lifetime rates of major depression and illicit drug abuse/dependence than did women with no such history. A history of childhood sexual abuse was also associated with higher rates of all disorders considered in women. In men, the prevalence of disorders tended to be higher among those who reported exposure to sexual abuse, but only the associations with alcohol abuse/dependence and the category of one or more disorders reached statistical significance. The relationship between a childhood history of physical abuse and lifetime psychopathology varied significantly by gender for all categories except for anxiety disorders. Although not statistically significant, a similar relationship was seen between childhood history of sexual abuse and lifetime psychopathology. CONCLUSIONS: A history of abuse in childhood increases the likelihood of lifetime psychopathology; this association appears stronger for women than men.     

Empathic sexual responses in heterosexual women and men

Two distinct empathic sexual responses have been mentioned anecdotally in the literature: (1) an increase in physiological sexual arousal in response to the sexual arousal of the partner (empathic turn-on) and (2) a decrease in physiological sexual arousal in response to lack of sexual arousal in the partner (empathic turn-off), but to our knowledge this is the first systematic study of the phenomenon. There were 722 women and 415 men who participated in the anonymous computer survey. Of the total of 1137 participants, 90.5% agreed that they had experienced empathic turn-on, 69.1% agreed that they had experienced empathic turn-off, 64.4% agreed that they had experienced both empathic turn-on and turn-off and only 4.7% had experienced neither, χ ² (1, n = 1137) = 19.484, p < .001. Sexual satisfaction of participants was significantly lower at the levels of partner's orgasm likelihood below 0.5 than above 0.5 in both men and women when analyzed separately. Both men and women were more likely to express multiple or sustained orgasms (instead of single orgasms) with a good partner than while masturbating. Empathic sexual responses can modulate the sexual arousal of both men and women by increasing sexual arousal when the partner is aroused and decreasing sexual arousal when the partner is not sexually responsive.