Cognitive and emotional predictors of female sexual dysfunctions: Preliminary findings
ABSTRACT The influence of cognitive and emotional variables on specific female sexual dysfunctions was investigated. A total of 207 women (160 without sexual problems and 47 with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis of sexual dysfunction) answered a set of questionnaires assessing cognitive and emotional variables (cognitive schemas activated in sexual context - Questionnaire of Cognitive Schema Activation in Sexual Context (QCSASC); sexual beliefs - Sexual Dysfunctional Beliefs Questionnaire (SDBQ); automatic thoughts and emotions presented during sexual activity - Sexual Modes Questionnaire (SMQ)); and sexual functioning (Female Sexual Function Index (FSFI)). Results indicated that most women with sexual dysfunction activate incompetence schemas when facing unsuccessful sexual situations. Additionally, lack of erotic thoughts and increased attentional focus on failure and disengagement thoughts during sexual activity were also common in the clinical sample. Besides these common factors, results showed that some specific cognitive and emotional factors are associated with different clinical presentations. Sexual conservative beliefs seem to be closely related to hypoactive sexual desire and to a certain extent to arousal difficulties in women. Body image beliefs and automatic thoughts focusing on self-body appearance seem to be strongly associated with orgasmic disorder. Regarding emotions, fear was one of the best predictors of vaginismus, whereas sadness, disillusion, guilt, and lack of pleasure and satisfaction were closely associated to hypoactive sexual desire. Overall, these findings may contribute to the discussion regarding the treatment strategies used for the different female sexual dysfunctions.
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ABSTRACT: Over the last decades, women’s sexual life has recorded some noticeable changes, along with new light-shedding perspectives on the understanding of women’s sexuality. A relevant set of studies highlight the importance of different biological, psychological and social dimensions as determinants of sexual functioning and satisfaction, although only a few of them consider those dimensions in an integrated and interdependent way, in order to ascertain each dimension’s significance. Furthermore, and despite the close relation between sexual functioning and sexual satisfaction, the existing literature tends to show some confusion and overlapping between both concepts. Considering this, the present study is intended to analyse the main relational, psychological, contextual and biomedical predictors of women’s sexual functioning and satisfaction, as well as to explore the relation between these two dimensions of women’s sexuality. In this light, using a sample of 497 women, ten empirical studies were conducted, based on queries aimed at assessing the participants’ social and demographic characteristics, medical history and lifestyle, psychopathology, well-being, cognitive and affective variables, relational aspects, sexual context, sexual activity, sexual functioning and sexual satisfaction. Results suggested significant differences between women with high and low levels of sexual functioning, and between high and low levels of sexual satisfaction regarding the various dimensions analysed. On the other hand, the combined analysis of all the biopsychosocial dimensions confirmed the unequivocal contribution of the psychological variables to explain women’s sexual functioning, particularly the role of self-awareness of one’s pleasure during sexual activity, the satisfaction and contentment that derive from meaningful sexual experiences, as well as sexual self-esteem, that is, the image that the woman has of herself as a sexual being. As to the other dimensions considered, only the use of cardiotonic drugs significantly predicted reduced sexual functioning, whereas age, or other social and demographic variables, diseases and the perception of one’s health, menopausal state, lifestyle, psychopathology, general concerns during sexual activity or other contextual variables have shown no predictive value. Regarding sexual satisfaction, the best predictors were the emotional variables, especially the specific responses of joy and absence of guilt during sexual activity, as well as relational aspects, particularly the relationship’s quality, but also the presence of a sensitive partner to the woman’s needs and sexual preferences. Furthermore, cognitive variables have also shown a significant role, such as women resorting to sexual fantasies and minding their behaviour during sexual activity, contributing to an increased sexual satisfaction. Besides that, sexual self-esteem and the ability to achieve orgasm during sexual encounters were also significant predictors of satisfactory sexual experiences. Conversely, no medical, sociodemographical, lifestyle or psychopathological variables have shown any predictive value for sexual satisfaction. In a simultaneous analysis of the different biopsychosocial predictors of women’s sexual functioning, cognitive and emotional determinants stand out. Concerning satisfactory sexual experiences, besides those, relational aspects also played a central role, all the more important given the close relation and circularity between sexual functioning and sexual satisfaction. However, these two dimensions of women’s sexual experience seem to have different predictors, thus supporting the need for a differentiated and specific approach, whether in empirical studies or in interventions. In general, this study was intended to fill a void in the research field regarding women’s sexual experiences, in a positive perspective (both sexual functioning and satisfaction), enabling a deeper knowledge on its determinants, with repercussions for clinical intervention and for the promotion of a more gratifying women’s sexual life.03/2011, Degree: doctorate, Supervisor: Pedro Nobre; Jose Pinto-Gouveia
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ABSTRACT: Abstract Empirical research suggests that emotional response during sexual activity discriminates between sexually functional and dysfunctional heterosexual men and women, with clinics presenting lower positive and higher negative affect. However, there is no evidence about the role of emotions in gay men and lesbian women with sexual problems. The current study analyzed affective states during sexual activity in homosexual and heterosexual men and women, with and without sexual problems. One-hundred and fifty-six men and 168 women participated in the study. A 2 (group) x 2 (sexual orientation) MANOVA was performed. Participants completed a web-survey assessing sexual functioning and the PANAS. Findings indicated a main effect of group, with groups with sexual problems reporting significantly more negative and lower positive affect compared to men and women without sexual problems, regardless of sexual orientation. However, findings have also shown an interaction effect in the male sample with gay men, contrary to heterosexual men, reporting similar affective responses regardless of having a sexual dysfunction or not. Overall, findings emphasize the role of affective responses during sexual activity in men and women with sexual problems, suggesting the importance of addressing emotional responses in assessment and treatment of sexual problems in individuals with different sexual orientations.Journal of Sex and Marital Therapy 12/2014; DOI:10.1080/0092623X.2014.996929 · 1.27 Impact Factor
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ABSTRACT: The role of cognitive schemas on sexual functioning has been studied in samples of heterosexual men and women. However, there are no published studies on the impact of cognitive schemas on sexual functioning in gay men or lesbian women. The current study analyzed the differences in cognitive schemas associated with negative sexual events in a sample of heterosexual and homosexual men and women, with and without sexual problems. A total of 168 women and 148 men completed a web-survey. Participants answered questions about self-perceived sexual problems, and completed the Questionnaire of Cognitive Schemas Activated in Sexual Context (QCSASC). Results for men and women were analyzed in separate MANOVAs (sexual problems x sexual orientation). Men with sexual problems scored significantly higher in negative cognitive schemas when facing an adverse sexual episode compared with sexually healthy men, regardless of sexual orientation. Women with sexual problems also scored significantly higher in Undesirability/rejection, Incompetence, and Difference/loneliness schemas when compared women without sexual problems, regardless of sexual orientation. Also, sexual orientation was also found to have a significant effect among women, with lesbian women activating significantly more Undesirability/rejection, Difference/loneliness, and Helpless schemas, than heterosexual women. Overall, findings suggest that, despite some specific patterns particularly in lesbian women, the role of cognitive schemas on sexual functioning is very similar in heterosexual and homosexual men and women. These results highlight the core role of cognitive factors on sexual problems in gay men and lesbian women.Cognitive Therapy and Research 12/2014; DOI:10.1007/s10608-014-9661-5 · 1.70 Impact Factor