John Wincze

Brown University · Department of Psychiatry and Human Behavior

We evaluated the responsiveness and treatment sensitivity of the Erection Quality Scale, and provided further psychometric validation of this scale. An 8-week, placebo controlled, randomized clinical trial investigating the efficacy and safety of vardenafil in patients with erectile dysfunction was performed. The Erection Quality Scale, together wi...

The role of psychological and interpersonal factors in the treatment of erectile dysfunction (ED) with sildenafil or other oral therapies has not been sufficiently investigated. We conducted a pilot study of psychosocial predictors of pharmacotherapy treatment outcome and satisfaction in men with ED and their partners. Sixty-nine men with mild to m...

This study examined the effects of supplementing sildenafil (Viagra) with use of a cognitive-behavioral treatment manual plus minimal therapist contact. Participants were 6 heterosexual couples in which the man met criteria for erectile dysfunction and was using sildenafil. Erectile dysfunction resulted from psychological factors or psychological a...

Men with and without sexual dysfunction present with varying patterns of agreement between subjective estimates of sexual arousal and more objective psychophysiological measures of the same construct. This relative accuracy seems to be associated with sexual function, with men who have sexual dysfunction presenting less accurate estimations (mostly...

The Erection Quality Scale (EQS) is a new, self-report measure for assessing the quality of penile erections. It is intended to complement existing diagnostic and outcome measures (eg, International Index of Erectile Function, Sexual Encounter Profile) in both clinical practice and outcomes research in erectile dysfunction (ED). The initial phases...

After viewing 2 sexually explicit films, 52 sexually functional participants were given bogus feedback indicating a low erectile response. The men were given either an external, fluctuating attribution (i.e., poor films) or an internal, stable attribution (i.e., problematic thoughts about sex) for the low arousal. As hypothesized, participants in t...

The current investigation explores possible reasons for the poor overall success rates of medical techniques used in the treatment of erectile dysfunction. This is the first study to compare directly the psychological impact of a mechanically produced versus an erotically produced erection. Subjective and objective parameters of sexual arousal were...

With the advent of DSM-III in the USA (1), a new disorder termed generalized anxiety disorder (GAD) was established separately from panic disorder. Because GAD was relegated to a residual category, it soon became a confusing diagnosis. Although revisions in DSM-III-R (2) removed GAD as a residual category, they also complicated the clinical examina...

This study assessed perceived changes in sexual behavior and body image after weight loss in a clinically obese population. Thirty-two women enrolled in a hospital-based multidisciplinary weight management program completed retrospective questionnaires about their sexual functioning and body image before and after weight loss. Subjects reported sig...

Despite prohibitions by the ethical codes of all major mental health professions, therapist sexual misconduct remains a serious problem. Over the past 13 years, individual states have enacted laws regarding therapist sexual misconduct with the hope of more successfully curbing this behavior. The laws fall into four categories; civil, criminal, repo...

Despite prohibitions by the ethical codes of all major mental health professions, therapist sexual misconduct remains a serious problem. Over the past 13 years, individual states have enacted laws regarding therapist sexual misconduct with the hope of more successfully curbing this behavior. The laws fall into four categories; civil, criminal, repo...

In this study, the authors surveyed all licensed psychologists in the state of Rhode Island and in the state of Western Australia, Australia, and asked them if they had treated clients who had been sexually abused by a former therapist. Surveys distributed in both states were nearly identical, with only minor differences to conform to local convent...

In this study, the authors surveyed all licensed psychologists in the state of Rhode Island and in the state of Western Australia, Australia, and asked them if they had treated clients who had been sexually abused by a former therapist. Surveys distributed in both states were nearly identical, with only minor differences to conform to local convent...

Thermal biofeedback is widely used to treat various clinical disorders. Given its widespread utility, and the variability among the biofeedback systems currently on the market, it is important to investigate which systems are most effective for training various skills. This study compared the performance of normal subjects on two different computer...

Thermal biofeedback is widely used to treat various clinical disorders. Given its widespread utility, and the variability among the biofeedback systems currently on the market, it is important to investigate which systems are most effective for training various skills. This study compared the performance of normal subjects on two different computer...

In this study, the authors surveyed all licensed mental health professionals in the state of Rhode Island and asked them if they had treated clients who had been sexually abused by a former therapist. Twenty-six percent of the respondents reported having treated victims of therapist sexual abuse. In addition, the treating therapists reported 120 in...

In this study, the authors surveyed all licensed mental health professionals in the state of Rhode Island and asked them if they had treated clients who had been sexually abused by a former therapist. Twenty-six percent of the respondents reported having treated victims of therapist sexual abuse. In addition, the treating therapists reported 120 in...

Diabetes mellitus, a major health problem afflicting 500,000 Americans each year, is a leading cause of male erectile difficulties. Diabetic women may be susceptible to a similar diabetic pathogenesis for sexual problems but information about the effect of diabetes on female sexual response is sparse and conflicting. Past research has been based up...

Studies on sexual behavior frequently require that subject volunteers engage in intrusive/sensitive assessment procedures. While earlier investigators have found that these demands may result in volunteer bias (volunteers differing from nonvolunteers), these studies were limited to nonclinical samples. The present study involved 182 males admitted...

A double-blind, partial crossover study on the therapeutic effect of yohimbine hydrochloride on erectile dysfunction was done in 82 sexually impotent patients. All patients underwent a multifactorial evaluation, including determination of penile brachial blood pressure index, cavernosography, sacral evoked response, testosterone and prolactin deter...

The erectile responses of 13 nondysfunctional males and 48 dysfunctional males were compared during Nocturnal Penile Tumescence (NPT) and during exposure to erotic videotapes. The results showed distinct patterns of NPT and daytime responding that could differentiate the various subgroups: those displaying (i) no dysfunction; (ii) vasculogenic erec...

Two hundred twenty-one first-year medical students participated in a voluntary coronary heart disease risk factor self-change project designed to teach the principles of behavioral change. Blood pressure, serum lipids, percentage body fat, cardiovascular fitness, and smoking status were measured prior to the project. Students designed their own pro...

Twenty men with incomplete penile erection or inability to maintain an erection were evaluated to determine if venous leakage was a cause. Cavernosography was performed in conjunction with artificial erection induced by infusion of saline into the corpus cavernosa. Thirteen patients requiring higher than normal rates of saline infusion to achieve o...

Three chronic pedophiliac sex offenders were treated individually with medroxyprogesterone acetate (MPA) over a minimum of 3 months. Genital and subjective response to erotic stimulation, nocturnal penile tumescence, self-reporting of sexual urges, and testosterone levels were recorded repeatedly throughout the study. A single-subject reversal desi...

Eleven impotent men underwent deep-penile-vein arterialization after preoperative assessment by a multidisciplinary team. Penile Doppler pressures, testosterone levels, and nocturnal penile tumescence were used to establish a vasculogenic etiology. Cavernosography, artificial erection by saline infusion, and selective hypogastric arteriography were...

Patterns of sexual arousal were examined for eight male and eight female homosexuals. Comparisons were made in terms of physiological and subjective arousal. The results indicate that for each group there exists very distinct arousal responses, with each group showing the greatest response to same-gender homosexual activity. Results are discussed i...

A behavioral self-change project appears to be a useful means of integrating behavioral medicine into the medical school curriculum. Students were encouraged to learn measurement principles, sources of error, and how their risk factor values compared with population values. At the same time, students were exposed to behavioral principles and were a...

The structural patterns of sexual arousal are examined for eight male and eight female heterosexuals. Comparisons are made in terms of physiological and subjective arousal. The results indicate (1) that males and females differ in both the direction and magnitude of their arousal response to a variety of erotic stimuli and (2) that there is a stron...

Describes a behavioral model that is used as a framework for the assessment and treatment of sexual disorders. The model emphasizes a multidisciplinary approach leading to the development of individually tailored treatment programs. The following assessment techniques and procedures are discussed: self-report measures, behavioral measures, and phys...

Clinical programs for the treatment of impotence generally have been successful but without experimental verification of their individual components or factors associated with the development of impotence. Twenty-four normal males participated in an investigation comparing factors believed to inhibit or facilitate penile tumescence. The effects of...

Serum testosterone concentration of 24 human males was correlated with penile diameter changes in response to erotic stimuli. Mean testosterone concentration was significantly and negatively correlated with latency to maximum tumescence and it is hoped that this finding will shed light on the psychophysiological mechanisms involved in normal and im...

The effect of emotional arousal on subsequent sexual arousal was assessed in 14 18–34 yr old men. Ss initially viewed either 1 of 2 emotionally arousing videotapes (depression-and-anger or anxiety-and-anger producing) or a neutral videotape (a travelogue), each of which was followed by an erotic videotape. Sexual arousal was measured physiologicall...

Instrumentation has been developed which promises to further our understanding of the relationship between cognitive and physiological factors in the sexual arousal process. Past research has examined this relationship by continuous measurement of genital response, and discrete posttest measurement of subjective arousal. The self-report or cognitiv...

Five women experiencing low sexual arousal were exposed to a multiple measures analysis of their sexual behavior before and after undergoing a comprehensive sex therapy program. Measures included: (1) clinical interview, (2) behavioral record, (3) self-reported ratings of sexual and anxiety arousal, and (4) physiological records. Results showed tha...

An infrared-light measure was used to compare three methods of producing vaginal blood volume (VBV) increases: (a) VBV increases alone, (b) erotic fantasy alone, and (c) VBV biofeedback in combination with erotic fantasy and knowledge of the target response. A single-subject experimental design was used with two subjects, and time-series analyses w...

Six sexually normal women were exposed to a wide variety of erotic video tapes while vaginal, groin, and breast vasocongestion measures were tkane. The women indicated their level of sexual arousal while viewing the tapes by positioning a lever device along a calibrated scale. The results indicated highly significant positive correlations among the...

Tested J. Wolpe's (1958) prediction that autonomic sexual and anxiety arousal states are mutually inhibitory. Using a new physiological measure of female sexual arousal (vaginal blood volume), changes in 7 sexually experienced Ss (mean age 27 yrs) were compared during erotic video stimulation following anxiety and control stimulus preexposure and d...

This report describes the development of a self-report Sexual Arousability Inventory (SAI) for women. Sexual arousability was defined as the sum of a respondent's ratings of 28 erotic experience along a 7-point Likert arousal dimension. Multiple-regression and factor analyses were used to select valid items from a 131-item pool and build in factori...

Twenty-one women complaining of essential sexual dysfunction were treated by either systematic desensitization or video desensitization. In a cross-over design, seven subjects experienced a no-treatment control phase before receiving therapy. Video desensitization was more effective than systematic desensitization and both desensitization procedure...

The purpose of this investigation was to validate the use of vaginal photoplethysmography along with six other physiological measures for the assessment of sexual arousal in women. Six women in counterbalanced order were presented control, dysphoric, and sexually arousing videotapes. Subjective ratings revealed that subjects experienced moderate le...

Four self-referred adult male homosexuals were provided with therapy to increase their level of heterosexual responsiveness. Three underwent 40 sessions of orgasmic reconditioning using both visual and fantasied stimuli, in counterbalanced treatment sequences; one underwent 19 sessions of orgasmic reconditioning with visual stimuli and 17 sessions...

The purpose of this investigation was to determine how sexually dysfunctional and normal women differ in their physiological responsivity during, and subjective responsivity shortly after, exposure to an erotic stimulus. Utilizing analysis of covariance, subjects were equated on physiological basal measures as well as other relevant demographic and...

The effects of a new systematic desensitization procedure were evaluated in a case of sexual frigidity. Videotaped cassettes of heterosexual behavior were arranged in a hierarchy and shown to a 24-yr-old female by her husband who acted as therapist. Following seven sessions of this, significant improvement in the couple's heterosexual behavior was...

Prior research with token reinforcement in the psychiatric population has been directed at work adjustment, more than at major symptomatic behaviors. The purpose of the present research, on the other hand, was to investigate the effects of feedback and token reinforcement on the modification of delusional verbal behavior in chronic psychotics. Six...

Systematic desensitization was compared to “vicarious extinction” therapy in treating frigidity in a 29-year-old married female. Films of heterosexual behavior were shown to S during “vicarious extinction”. In spite of expectations of therapeutic improvement under both treatment conditions, S showed improvement only during systematic desensitizatio...

Obtained simultaneous measures of heart rate and approach behavior in the feared situation during treatment of 9 15-56 yr. Old phobic ss. In some cases heart rate increased as phobic avoidance behavior decreased. In other cases there was a parallel decline, a decline in phobic behavior without any change in heart rate, or a decreased heart rate onl...

Two studies are reported concerning the effectiveness of positive reinforcement of approach behavior or “shaping” in reducing college girls' fears of snakes, an analogue of clinical phobia. In the first study, “shaping” was found to be more effective than Systematic Desensitization in reducing behavioral avoidance of snakes, and equally effective i...

The technique of experimental analysis of a single case employing a sequential design and quantifiable behavioral measures was used to study the contribution of instructions and reinforcement to the modification of severe neurotic behavior. The overall effect of instructions was small or transient compared to that of reinforcement procedures which...

discuss the problem of male erectile disorder / provide a working definition of the problem, discuss its prevalence, and give an overview of the conceptual [biopsychosocial] model that guides our intervention / discuss the context of our clinical work, present our approach to assessment and treatment, and illustrate this approach with a recent clin...

The effect of systematic desensitization upon snake fearful subjects was compared in two conditions. In the first, relaxation was paired with imagined scenes of the snake, and in the second with a real snake. The second group improved more in a behavioral approach test and evidenced less anxiety as measured by GSR than the first group. The results...