Journal of Sex and Marital Therapy

Published by Taylor & Francis (Routledge)
Online ISSN: 1521-0715
Print ISSN: 0092-623X
This study describes a 30-item questionnaire, the Sexual Aversion Scale, that was used to assess sexual fears and avoidance in college students. The construct of sexual aversion was based on the newly listed DSM-III-R criteria for sexual aversion disorder. Results were obtained from 382 college students. The questionnaire was shown to have good internal consistency and test-retest reliability. Female students reported significantly more sexual anxiety. They expressed more fear of intercourse and the negative social consequences of their sexual behavior. They were also more inclined to avoid situations where they might become sexually involved. Conversely, males appeared to be more sexually frustrated and said they would become more sexually active were it not for fear of catching a sexually transmitted disease. It is concluded that sexual fears are fairly widespread among college students and are being fueled by the current AIDS crisis. One implication of these findings is that sexual aversion disorder may become a prevalent problem, especially if the AIDS epidemic continues to spread to the heterosexual population.
Characteristics of the Sample by Sex 
CSFQ-14 Psychometrics for the Total and Each Scale, by Sex 
CSFQ-14 Factor Analysis. Rotated Component Matrix, n = 6,268 
Internal Consistency (Cronbach's α) for Female and Male Versions of the Long-Form CSFQ (CSFQ) and Short-Form CSFQ (CSFQ-14): Scales and Total 
The Changes in Sexual Functioning Questionnaire (CSFQ) is a 36-item clinical and research instrument identifying five scales of sexual functioning. This study documents the internal consistency and factor structure of a 14-item version of the CSFQ (CSFQ-14), which yields scores for three scales corresponding to the phases of the sexual response cycle (i.e., desire, arousal, and orgasm) as well as the five scales of the original CSFQ. Factor analysis confirms the construct validity of the CSFQ-14 as a global measure of sexual dysfunction. The CSFQ-14 and the individual scales exhibit strong internal reliability.
Archival data from the Sex Therapy Center at Stony Brook were analyzed to determine the prevalence of desire phase sexual dysfunctions and the effectiveness of treating them with behavioral sex therapy. When cases were rediagnosed with a multi-axial problem-oriented system, increases from 1974-1981 in both the prevalence of desire phase problems and of male low sexual desire were observed. Data suggested that wives display more extreme patterns of sexual avoidance than do husbands in couples seeking sex therapy. Outcome statistics on marital adjustment, overall sexual satisfaction, the frequency of intercourse and masturbation, and patterns of initiation of sexual activity reveal significant positive changes after treatment. These changes are not due to nonspecific factors and are maintained at follow-up. Sex therapy was equally successful for male-centered vs. female-centered problems, for low sexual desire vs. aversion to sex, and for global or lifelong dysfunctions vs. the more recent or situational ones. Posttreatment gains reflect a minimally adequate sexual relationship, however, rather than an optimal degree of intimacy and pleasure.
Final model of marital functioning and psychological distress among older couples ( n = 394). All parameter estimates presented are standardized and significant at p < .05. Dotted lines refer to a nonsignificant parameter estimate. 
Descriptive Data of Men and Women at Both Times of Measure (N = 394 Couples)
Many authors have underlined the existence of a negative association between marital functioning and psychological distress. However, little is known about the direction of this association over time among older couples. This study examined the relation over time between psychological distress and marital functioning among 394 community-dwelling couples. The authors conducted dyadic data analyses to determine whether marital functioning at baseline (T1) predicted psychological distress 18 months later (T2), and inversely. The results for women suggested that marital and psychological functioning may each predict the other. The results for men showed that marital problems lead to more psychological distress. The authors found some significant partner effects: In both genders, the marital functioning of one spouse influenced the marital functioning of the other. Men's marital functioning at baseline significantly predicted women's psychological distress at T2. The authors conducted analyses also to determine how 6 patterns of change in marital functioning between times were associated with changes in psychological distress, and inversely. Changes characterized by an increase in psychological distress over time in at least 1 spouse were associated with a decrease in marital functioning. These findings underlined the importance for clinicians and researchers to pay closer attention to the association between these variables.
Students from four health sciences programs (Medicine, Nursing, Occupational Therapy and Physiotherapy) participated in a two-day Sexuality Workshop and completed pre- and post-workshop questionnaires dealing with sexual attitudes, comfort, and knowledge. Eighteen months later, these students were asked to complete the same questionnaires. Not only had they sustained the gains made during the workshop, but they continued to show improvement in the three areas during this interval. However, of greater importance than the positive finding is the need to understand the range of methodological problems encountered in carrying out this type of follow-up educational inquiry and in seeking measures for improving the validity and generalizability of such research.
In many cultures, the erect penis has been a symbol of masculine qualities. Because of this symbolism, a penis that is less than average size can cause insecurity or embarrassment. This series reports the authors' 18-year experience in the management of 60 men with a complaint of a small penis. For 44 of these 60 men, counseling was sufficient; the other 16 had surgery, and of these, 9 were satisfied with the result. Despite limitations, the authors conclude that those men who already achieve a penis length of no less than 7.5 cm (2.95 in) in erection, have only limited benefit from penis-enhancing surgery. This particular patient category should therefore be dissuaded from surgery.
Studies on epidemiology of female sexual problems consistently indicate high prevalence rates worldwide, suggesting that this clinical presentation should be considered as a public health concern. However, there are no published studies on prevalence of sexual problems in Portugal. The present study investigated the prevalence, severity, and comorbidity of female sexual problems in a Portuguese community sample. In addition, the authors assessed the role of sociodemographic predictors of women's sexual difficulties. The authors recruited 500 women using quota methods to resemble the Portuguese population according to its demographic characteristics. Participants answered to the Female Sexual Function Index and to a sociodemographic questionnaire. Findings indicated that 37.9% of the Portuguese women reported symptoms of sexual problems. Symptoms of lack of sexual desire was the most frequent sexual difficulty with 25.4% of the women reporting low desire most times or always, followed by symptoms of orgasmic (16.8%), sexual arousal (15.1%), and lubrication difficulties (12.9%), dyspareunia (9.8%), and vaginismus (6.6%). Results indicated that age was a significant predictor of female sexual problems. Results also indicated that symptoms of female sexual problems are a significant health concern in Portugal, suggesting that public policies should be developed to promote sexual health.
The term autogynephilia denotes a male's propensity to be sexually aroused by the thought or image of himself with female attributes. Some autogynephiles imagine themselves, in their sexual fantasies, as complete women. Others, here called partial autogynephiles, imagine themselves with a mixture of male and female anatomic features, usually women's breasts and men's genitals. Partial autogynephiles evince a particular sexual interest in those individuals known in the vernacular as she-males. These are men, often involved in prostitution or pornography, who have undergone breast augmentation while maintaining their male genitals. Partial autogynephiles appear less likely to pursue surgical sex reassignment than gender-dysphoric men whose erotic self-image includes a vagina. Some patients with a persistent desire for women's breasts but no or conflicted desires to live as women full-time or undergo vaginoplasty may be pacified with mildly feminizing doses of estrogenic hormones.
Using the interview method, three sexologists examined, over a period of 36 years, the sexual development and life of 2,425 gynecological patients who were sent to Franzensbad for after-treatment of conditions following gynecological inflammations or surgery. They had all been married at least 1 year and when interviewed were 20-40 years old. The average age at the time of the first coitus dropped from 20.75 among the women born in the decade 1911-1920 to 17.8 among those born between 1961 and 1970. As far as premarital sexual life is concerned, the number of young women with numerous coital partners before marriage has continuously increased since 1931. About 50% of young brides today had premarital sexual contacts with 1-3 partners. Over the decades between 1921 and 1970, the number of women with 4-10 premarital coital partners has increased from 1% to 12%. Among women born in the decade 1961-1970, there has been a distinct increase in those who achieve coital orgasm only rarely to 26%. This is the highest percentage of this type of insufficient sexual reactivity since 1911. This unfavorable change in sexual life of young married women is discussed in the context of negative social environmental factors in Czechoslovakia today. The study concludes with the opinion that frequency of coital orgasm in women is a sensitive indicator of social environmental influences in a given society.
This paper reviews the studies since 1970 which examined the treatment outcome of primary and secondary nonorgsmic women. The studies were evaluated within the following sections: subjects, therapists, time format, treatment, and outcome criteria. Many methodological deficiencies were found, most notably the lack of specificity regarding subject characteristics, a reliance on women's self-reports of outcome without obtaining partner validation, the failure to assess the influence of the woman's partner on her orgasmic responsivity, the failure to control for expectancy factors, and the use of different criteria for treatment success. The problems in the literature suggest that it is premature to place any confidence in the identification of the treatment format which is most successful for a defined population of women who experience a specific form of primary or secondary orgasmic dysfunction. The data tentatively suggest that (1) secondary nonorgasmic women would show greater gains than primary nonorgasmic women in treatments emphasizing sexual and nonsexual communication techniques, (2) primary nonorgasmic women would show greater gains than secondary nonorgasmic women in desensitization and sexual technique training procedures, (3) desensitization may be the appropriate treatment for women whose sexual anxiety contributes to secondary orgasmic dysfunction. These hypotheses should be examined in controlled research.
The purpose of this communication is to review recent marital trends in Japan, especially with reference to similar trends in the USA. Marital statistics can be difficult to interpret, especially since they are often calculated using differing methods. Where possible, an attempt has been made to recalculate Japanese statistics to make them more comparable with US ones.
I was very pleased when the Program Committee of SSTAR asked me to give the Laudatio for John Money, and I immediately agreed. There have been so many occasions over the last 20 years-while seeing patients, writing papers, and planning research-when I have been grateful for John's wisdom, knowledge, and friendship that I welcome the opportunity to join in honoring him today.
Top-cited authors
Rory C Reid
  • University of California, Los Angeles
Kenneth J. Zucker
  • University of Toronto
Pedro Nobre
  • University of Porto
Debby Herbenick
  • Indiana University Bloomington
Susan J Bradley
  • University of Toronto