Showing papers in "Journal of Sex & Marital Therapy in 2000"
TL;DR: The results support the reliability and psychometric (as well as clinical) validity of the Female Sexual Function Index (FSFI) in the assessment of key dimensions of female sexual function in clinical and nonclinical samples and suggest important gender differences in the patterning of femaleSexual function in comparison with similar questionnaire studies in males.
Abstract: This article presents the development of a brief, self-report measure of female sexual function. Initial face validity testing of questionnaire items, identified by an expert panel, was followed by a study aimed at further refining the questionnaire. It was administered to 131 normal controls and 128 age-matched subjects with female sexual arousal disorder (FSAD) at five research centers. Based on clinical interpretations of a principal components analysis, a 6- domain structure was identified, which included desire, subjective arousal, lubrication, orgasm, satisfaction, and pain. Overall test-retest reliability coefficients were high for each of the individual domains (r=0.79 to 0.86) and a high degree of internal consistency was observed (Cronbachs alpha values of 0.82 and higher) Good construct validity was demonstrated by highly significant mean difference scores between the FSAD and control groups for each of the domains (p<0.001). Additionally, divergent validity with a scale of marital satisfactio...
5,183 citations
TL;DR: The authors have developed the Arizona Sexual Experiences Scale (ASEX), a five-item rating scale that quantifies sex drive, arousal, vaginal lubrication/penile erection, ability to reach orgasm, and satisfaction from orgasm.
Abstract: Although sexual dysfunction is common in psychiatric patients, quantification of sexual dysfunction is limited by the paucity of validated, user-friendly scales. In order to address this problem, the authors have developed the Arizona Sexual Experiences Scale (ASEX), a five-item rating scale that quantifies sex drive, arousal, vaginal lubrication/penile erection, ability to reach orgasm, and satisfaction from orgasm. Possible total scores range from 5 to 30, with the higher scores indicating more sexual dysfunction. This study assesses the internal consistency, test-retest reliability, and convergent and discriminant validity of the ASEX.
893 citations
TL;DR: A model is presented that more accurately depicts the responsive component of women's desire and the underlying motivational forces that trigger it and to prevent diagnosing dysfunction when the response is simply different from the traditional human sex-response cycle.
Abstract: Clarification of women's sexual response during long-term relationships is needed. I have presented a model that more accurately depicts the responsive component of women's desire and the underlying motivational forces that trigger it. The variety of arousal/orgasm responses is also acknowledged. The purpose is both to prevent diagnosing dysfunction when the response is simply different from the traditional human sex-response cycle and to more clearly define subgroups of dysfunction. The latter would appear to be necessary before progress in newer treatment modalities, including pharmacological, can be made.
805 citations
TL;DR: Those women who reported greater cognitive distraction during sexual activity with a partner also reported relatively lower sexual esteem, less sexual satisfaction, less consistent orgasms, and higher incidence of pretending orgasm.
Abstract: Past research on the role of cognitive distraction in sexual dysfunction typically has focused on males and has been conducted in the laboratory using artificial stimuli. In the current study, young adult women (N = 74) with coital experience completed questionnaires regarding cognitive distraction and their sexuality. Those women who reported greater cognitive distraction during sexual activity with a partner also reported relatively lower sexual esteem, less sexual satisfaction, less consistent orgasms, and higher incidence of pretending orgasm even after the women's general affect, sexual desire, general self-focus, general sexual attitudes, and body dissatisfaction were statistically controlled. Results are discussed with regard to directions for future research and implications for sex therapy.
332 citations
TL;DR: Results showed that the collaborative conflict management style has the highest correlation with both marital satisfaction and spousal satisfaction with conflict management in the marriage.
Abstract: The aim of this study was to investigate whether there is one conflict management style that correlated more significantly with marital satisfaction than any other. In addition, spousal satisfaction with how marital conflict is managed was also examined, as were gender differences. Fifty-seven couples who had been married for at least 10 years took part in the study. Results showed that the collaborative conflict management style has the highest correlation with both marital satisfaction and spousal satisfaction with conflict management in the marriage. In contrast, where one or both of the spouses used the competitive conflict management style, the lowest marital satisfaction was reported. The results were also interpreted in terms of cultural and gender differences.
157 citations
TL;DR: Study results suggest that interventions should emphasize the importance of objectively assessing HIV/STD risk before reducing condom use within relationships and need to provide additional information on the riskiness of heterosexual anal sex.
Abstract: Two hundred ten heterosexual undergraduates in dating relationships were surveyed about reasons for not using condoms every time for vaginal and anal sex and for increasing or decreasing condom use during their relationships. Half of the respondents reported consistent condom use in the first month of their relationships, while only 34% reported consistent condom use in the past month. Subjective assessments of partner safety and the belief that sufficient measures were being taken to avoid pregnancy were important reasons for condom nonuse. Study results suggest that interventions should emphasize the importance of objectively assessing HIV/STD risk before reducing condom use within relationships. Interventions also need to provide additional information on the riskiness of heterosexual anal sex.
128 citations
TL;DR: Responses to a questionnaire asking about satisfaction and problems in the sex lives of respondents and their partners were sent to 4,000 adults registered with general practices in England, and those who were dissatisfied were more likely to report that their partner was dissatisfied with their sex life.
Abstract: A questionnaire asking about satisfaction and problems in the sex lives of respondents and their partners was sent to 4,000 adults registered with general practices in England. A quarter of respondents said that they were dissatisfied with their sex lives, men more so than women, particularly with the frequency of intercourse. Respondents were more likely to be dissatisfied with their sex life if they perceived their partner to have a sexual problem. Respondents who were dissatisfied were more likely to report that their partner was dissatisfied with their sex life. The benefits of treating sexual problems have wide implications for both partners in a relationship.
119 citations
TL;DR: It would seem that marital and sex therapists are better equipped than most to provide mental health services to breast cancer patients.
Abstract: The trauma of being diagnosed and treated for breast cancer can impact greatly on womens' psychosexual functioning and intimate relationships. Survivors of breast cancer report that issues of body image, sexuality and partner communication rarely are addressed by traditional health care providers (Ganz, Rowland, Desmond, Meyerowitz, & Wyatt, 1998). Psychotherapy can help women cope with difficult changes in body image and sexual functioning, and there is evidence that psychotherapy may prolong life (Speigel, Bloom, Kraemer, & Gottheil, 1989). However, many mental health professionals are not comfortable addressing sexual issues, nor are they well versed in the medical aspects of the disease and its treatment. It would seem that marital and sex therapists are better equipped than most to provide mental health services to breast cancer patients.
99 citations
TL;DR: A single mid-cycle blood sample was obtained from 15 premenopausal female patients presenting with lifelong absence of sexual drive and from a control group of women with intact sexual drive, finding that average coital frequency correlates with free testosterone index.
Abstract: A single mid-cycle blood sample was obtained from 15 premenopausal female patients presenting with lifelong absence of sexual drive and from a control group of women with intact sexual drive. Serum levels of testosterone, 5-dihydrotestosterone (5-DHT), 17s oestradiol, sex hormone binding globulin, and prolactin were measured and indices of free testosterone and 5-DHT were derived. During the menstrual cycle in which the blood samples were obtained, the study subjects kept a diary of their sexual desire and activities. The only endocrine parameter that is significantly different between the two groups is free testosterone, which is lower in the patients than in the control women. Associations between endocrine parameters and indices of sexual behavior were examined. In the control group, average daily sexual thoughts correlates positively with total testosterone, free testosterone index, and free 5- DHT. Feeling of "need for sex" correlates positively with free 5-DHT index and free testosterone index. Expe...
95 citations
TL;DR: Treatment should determine the specific type of PE and comprehensively address its particular features in order to improve long-term treatment effectiveness.
Abstract: This article distinguishes several subtypes of biogenic and psychogenic premature ejaculation (PE) according to their etiologic features: the physiological PE types of (a) neurologic constitution, (b) acute physical illness, (c) physical injury, and (d) pharmacologic side effect; and the psychological PE types of (a) psychological constitution, (b) acute psychological distress, (c) relationship distress, and (d) psychosexual skills deficit. Attention is given to assessment and differential diagnosis, and to specific treatment of the types of PE, such as the pharmacologic management of difficult neurologic cases. Effective psychosexual treatment combines multiple strategies such as physiological relaxation, pubococcygeal muscle training, cognitive and behavioral pacing strategies, and the involvement of the partner in the therapy. Treatment should determine the specific type of PE and comprehensively address its particular features in order to improve long-term treatment effectiveness.
84 citations
TL;DR: Bupropion-SR may be a useful agent for treating orgasmic delay and inhibition, and possibly disorders of sexual arousal.
Abstract: The objective of this study was to determine whether the aminoketone antidepressant bupropion has beneficial effects in orgasmic dysfunction. Design: Single-blind, sequential treatment order of three weeks each: placebo, bupropion-SR 150 mg/day, bupropion-SR 300 mg/ day Subjects: Nondepressed women ( n = 20) and men ( n = 10) having nonphysiologic orgasmic delay or inhibition Main Outcome Measures: Reported difficulty or delay in achieving orgasm, satisfaction with orgasm and erectile function, and subjective impressions of drug effect Results: In the women, there were significant improvements relative to baseline ( p < .01) on both doses of bupropion-SR in all measured aspects of sexual function, and significant improvements relative to placebo ( p < .05) in overall sexual satisfaction on both doses and satisfaction with intensity of orgasm on 150 mg/day (300 mg/day, p = .10). In the men, significant improvements over baseline ( p < .01) were observed with both doses in overall sexual satisfaction, abili...
TL;DR: The psychometrc properties of the Spanish version of the CSFQ indicate that it is a valid instrument for clinical use in treating depressed patients, and differences in the internal construct of the AmericanCSFQ and its Spanish equivalent are demonstrated.
Abstract: The aim of this study is to adapt and validate the Changes in Sexual Functioning Questionnaire (CSFQ) in Spanish. The CSFQ was administered to 206 depressed patients in different Spanish cities, to 326 health sciences students at the University of Oviedo, and to 48 workers undergoing routine health check-ups. The Hamilton Depression Rating Scale (HAM-D) was administered to the depressed patients. The average time spent answering the CSFQ was 15.19 minutes. The CSFQ discriminated the depressed patients from the workers and university students. In the three areas of reliability (internal, test-retest, and inter-rater), the coefficients obtained were greater than 0.80. The factor analysis demonstrated differences in the internal construct of the American CSFQ and its Spanish equivalent. The psychometrc properties of the Spanish version of the CSFQ indicate that it is a valid instrument for clinical use in treating depressed patients.
TL;DR: With further methodological refinements, ultrasonographic evaluation of clitoral blood flow will be adaptable for clinical and research use and is likely to become the standard physiological measure of female sexual arousal.
Abstract: The feasibility of reliably measuring clitoral blood flow using standard color Doppler ultrasonography was evaluated by two independent assessors in a sample of 40 pre- and post-menopausal women. High positive correlations with no significant mean differences between examiners were found for three major standard blood flow measures including maximum velocity, resistance, and pulsatility indices. With further methodological refinements, ultrasonographic evaluation of clitoral blood flow will be adaptable for clinical and research use and is likely to become the standard physiological measure of female sexual arousal.
TL;DR: The Coital Alignment technique, a basic physiological alignment that provides consistent and effective stimulation for female coital orgasm, has been evaluated in a series of controlled studies and indicates that some symptoms of sexual dysfunction considered to have their etiological foundations in pathology are the result of ineffective intercourse techniques.
Abstract: The Coital Alignment Technique (CAT), a basic physiological alignment that provides consistent and effective stimulation for female coital orgasm, has been evaluated in a series of controlled studies. An overview of the CAT is discussed as well as related studies including replication studies, and subsequent studies of Orgasm Consistency Training (OCT), which incorporates the CAT technique. Classic sex problems like female coital anorgasmia and premature ejaculation and modern day epidemic-level sex problems such as hypoactive sexual desire are analyzed in relation to a syndrome of sexual dysfunction symptoms devolving from failed intercourse. Studies indicate that some symptoms of sexual dysfunction considered to have their etiological foundations in pathology are the result of ineffective intercourse techniques.
TL;DR: Oral sildenafil may be an effective treatment for PISD and patients taking selective serotonin re-uptake inhibitors and benzodiazepines reported significantly more improvement in libido and overall sexual satisfaction.
Abstract: Ninety-two outpatients (31 women, 61 men) who were treated with oral sildenafil for psychotropic-induced sexual dysfunction (PISD) completed ratings of their sexual functioning pre- and posttreatment. Both women and men reported significant improvements (p = .001) in all domains of sexual functioning, with 88% reporting improvement in overall sexual satisfaction. Significant improvements were reported regardless of psychotropic medication type. However, patients taking selective serotonin re-uptake inhibitors reported less improvement in arousal, libido, and overall sexual satisfaction than did other patients, whereas patients taking benzodiazepines reported significantly more improvement in libido and overall sexual satisfaction. Oral sildenafil may be an effective treatment for PISD.
TL;DR: Those who had premarital counseling were more likely to use marital and family therapy services, at both subclinical and clinical levels of distress, than others who had not had such counseling before marriage.
Abstract: Data from 1,285 recently married soldiers who participated in the 1989 Army Family Research Program survey indicated that pre-marital counseling by itself had little effect on subsequent marital satisfaction. However, those who had premarital counseling were more likely to use marital and family therapy services, at both sub-clinical and clinical levels of distress, than others who had not had such counseling before marriage.
TL;DR: The case report of a 31-year-old patient of mine with both an inflamed prostate gland and, unknown to his doctor, premature ejaculation, both of which were treated successfully by the antibiotic ciprofloxacin.
Abstract: This article presents the case report of a 31-year-old patient of mine with both an inflamed prostate gland and, unknown to his doctor, premature ejaculation, both of which were treated successfully by the antibiotic ciprofloxacin.
TL;DR: The majority of training programs in psychiatry provide curriculum offerings in sexuality training, primarily through didactic education.
Abstract: The current status of training in human sexuality is relevant to all health care professionals. The purpose of the current study was to determine the extent of sexuality training offered in psychiatric residency programs. The training directors of psychiatry residencies were surveyed with regard to the number of expert faculty in sexuality training as well as resident exposure to seven related curricular areas. Of the 69 respondents, the majority reported expert faculty in sexual dysfunctions, sex therapy, therapy with gay/lesbian patients, and HIV/AIDS. For each sexuality topic, approximately 80% of programs reported curricula offerings through either didactics or clinical rotations. For didactics, most topics were presented in the context of a broader course. With the exception of HIV/AIDS, it was rare for programs to offer a clinical rotation involving sexuality issues. In conclusion, the majority of training programs in psychiatry provide curriculum offerings in sexuality training, primarily through didactic education. Results are discussed with regard to comparison to training in professional psychology and the need for assessment of sexuality training in health care professions generally.
TL;DR: A case is presented of a 49-year-old man who amputated his penis following instructions that he had obtained from the Internet, which evolved into eroticized genital mutilation in a setting of depression due to environmental stressors.
Abstract: A case is presented of a 49-year-old man who amputated his penis following instructions that he had obtained from the Internet. The patient had a long-standing amputee fetish, which evolved into eroticized genital mutilation. The transformation of the preferred fetish occurred in a setting of depression due to environmental stressors. The literature about amputee fetishism, also called "apotemnophilia," is reviewed, and possible connections with the genital mutilation are discussed.
TL;DR: It was found that women who have high anxiety scores on the PAI and have a history of sexual abuse reported higher numbers of unwanted pregnancies, while sexual abuse history was not associated with numbers of unwelcome pregnancies for women with lower levels of anxiety.
Abstract: This study examined the additive, interaction effects of emotional status with sexual abuse on adult sexual functioning and sexual responsibility. The Golombok Rust Inventory of Sexual Satisfaction (GRISS; Rust & Golombok, 1986), the Personality Assessment Inventory (PAI; Morey, 1991), and a questionnaire regarding sexual experiences, number of unwanted pregnancies, number of unsafe sexual partners, and sexual abuse history, were administered to 200 psychology students. One hundred and forty-three participants were retained in the study. Two-way multivariate analyses of variance (MANOVA) were conducted for the sexual functioning variables (as measured by the GRISS), while two-way analyses of variance (ANOVA) were conducted for the sexual irresponsibility variables (as measured by the sexual experiences questionnaire). It was found that women who have high anxiety scores on the PAI and have a history of sexual abuse reported higher numbers of unwanted pregnancies, while sexual abuse history was not associated with numbers of unwanted pregnancies for women with lower levels of anxiety. Results were not significant, however, for the sexual functioning variables. In addition, depression and alcoholism did not have interacting effect on the association between sexual abuse history and any of the sexuality variables. These results may suggest that the effects of sexual abuse on adult sexuality may not be as pervasive as was once thought.
TL;DR: This intent-to-treat study adds more evidence of Viagra's effectiveness and further clarifies the need to focus on psychodynamic considerations when trying to assist the majority of patients who did not have ideal outcomes.
Abstract: The clinical responses of 58 men who were given Viagra between April and December 1998 in a psychiatric outpatient setting were tracked through 2 follow-up visits. Four categories of success and 3 categories of failure are defined to describe the outcomes. Although 43% had ideal outcomes--cure or uncomplicated drug-dependent successes--50% again were able to have intercourse and 63% experienced improved erections. Seventeen percent of the original sample did not benefit from the drug; 21% were lost to follow-up. This intent-to-treat study adds more evidence of Viagra's effectiveness and further clarifies the need to focus on psychodynamic considerations when trying to assist the majority of patients who did not have ideal outcomes.
TL;DR: Results showed that perceived dysfunctional family-of-origin rules had a negative impact on the perceived expression and experience of these three kinds of intimacy in dating relationships.
Abstract: This study examined the relationship between perceived dysfunctional family-of-origin rules and intimacy in single young adult dating relationships. A sample of 754 single, Caucasian-American young adults completed measures of perceived dysfunctional family-of-origin rules and emotional, intellectual, and sexual intimacy in dating relationships. When controlling for the effects of gender and age, results showed that perceived dysfunctional family-of-origin rules had a negative impact on the perceived expression and experience of these three kinds of intimacy in dating relationships. Implications for relationship therapy are discussed.
TL;DR: In this article, the authors used an anonymous questionnaire administered to 438 never-married undergraduate women to investigate the failure of college women to ask new sex partners about sexual histories prior to sexual intercourse.
Abstract: Despite efforts of sexuality educators, many college women are uninfluenced by information about risks of contracting a sexually transmitted disease or initiating an unintentional pregnancy. This study used an anonymous questionnaire administered to 438 nevermarried undergraduate women to investigate the failure of college women to ask new sex partners about sexual histories prior to sexual intercourse. Significant differences were found between the three subsample groups: those who "almost always" (AA), "sometimes" (S), or "rarely" (R) asked their sex partners about sexual histories. At first sexual intercourse, AA group women were significantly more likely to have been in a committed relationship, to have been contracepted, and to have been older; and they were less likely to have been under the influence of alcohol or other mind-altering substances. Furthermore, AA group women also reported fewer sex partners than other respondents. They also were more likely to discuss sexually related topics with the...
TL;DR: Unlike the intrapsychic mechanism for self-esteem regulation in males as a basic component of perversion-extrapsychically (compensationally) culminating in an output of sexual impulses, a functional stabilization of the female selfconcept seems more likely if conflict drives were to be focused on reproductional aspects and not on sexuality as discussed by the authors.
Abstract: Unlike the intrapsychic mechanism for self-esteem regulation in males as a basic component of perversion-extrapsychically (compensationally) culminating in an output of sexual impulsesa functional stabilization of the female self-concept seems more likely if conflict drives were to be focused on reproductional aspects and not on sexuality It therefore seems more suitable to use a new expression in linguistic analogy to perversion: ''reproversion The case history gives an example of a clinical manifestation of ''reproverse symptom formation The general survey describes the main points of view inregard to clinically oriented differentiation, ie, intensity, ego-proximity in the personality structure, and one's own self-acceptance within ''reproverse symptom formation Underlying personality disturbances are also discussed The significance of reproversion is relevant to many different specialized medical fields This is explained in conclusion, using the examples of denied pregnancy and infanticide at b
Journal Article•
TL;DR: In this paper, Sildenafil for St. John Wort-Induced sexual dysfunction was used for the treatment of sexual dysfunctions in a clinical setting.
Abstract: (2000). Sildenafil for St. John Wort–Induced Sexual Dysfunction. Journal of Sex & Marital Therapy: Vol. 26, No. 4, pp. 357-358.
TL;DR: Although there was notable similarity in what men and women most valued in a potential long-term sex partner, there were gender differences with regard to ratings of several of the items.
Abstract: The objective of the current study was to further examine gender differences in preferences for particular characteristics in a sexual partner and to investigate the extent to which men and women accurately estimate the preferences of the other gender. Heterosexual college students (185 men, 244 women) rated a diverse set of characteristics in a hypothetical sexual partner with whom they were presumed to be involved in an ongoing relationship. Participants also responded to the same set of items with regard to estimates of the ratings of the other gender (order of presentation was counter-balanced). Although there was notable similarity in what men and women most valued in a potential long-term sex partner, there were gender differences with regard to ratings of several of the items. Also, men and women under- or overestimated the ratings of the other gender with regard to several characteristics. Results are discussed with regard to implications for intervention as well as directions for future research.
TL;DR: Research by Bártová, Náhunek, Švestka, and Hajnová (1979), who were the first to use lithium in ambulatory protective treatment, is mentioned.
Abstract: I would like to contribute a few notes on professor Richard Balon’s (1998) article which mentions, among other things, research by Bártová, Náhunek, Švestka, and Hajnová (1979), who were the first to use lithium in ambulatory protective treatment. The sample included 40 subjects with sexual deviations classified according to ICD IX; comorbidity was rare. The patients were treated by diethylstilbestrol, replacement of which by lithium was indicated by undesirable side effects. Three cases of relapse occurred after 8 months of treatment, which was the same as in the stilben treatment with the same patient group; fewer side effects were reported during the lithium cure. In 1986 (Burešová, Bártová, & Švestka, 1990; Burešová, Bártová, Hajnová, Náhunek, & Švestka, 1986), another open-controlled study was published, containing an intraindividual comparison of cyproteronacetate, lithium, and oxyprothepine decanoate administration in 34 patients; the difference in relapse rate did not reach statistic significance. The postulated criteria for an ideal drug for paraphilia treatment were the following:
TL;DR: A GID case is presented followed by a discussion on GID patients in Japanese culture, social pressures upon diagnosis and treatment of GID, and social changes that have brought about the possibility for GID diagnosis and Treatment.
Abstract: Gender identity disorder (GID) has been attracting increasing attention in recent years in Japan as well as in the rest of the world. This report presents a GID case followed by a discussion on GID patients in Japanese culture, social pressures upon diagnosis and treatment of GID, and social changes that have brought about the possibility for GID diagnosis and treatment.