Tierney Kyle Ahrold LorenzUniversity of Nebraska at Lincoln | NU · Center for Brain, Biology and Behavior
Tierney Kyle Ahrold Lorenz
Ph.D.
About
105
Publications
35,081
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
1,655
Citations
Introduction
I study sexual health and wellbeing in women across many factors, including psychosocial, clinical, endocrine, autonomic and immune measures.
Additional affiliations
August 2018 - present
August 2016 - May 2018
August 2013 - July 2016
Education
August 2006 - August 2013
Publications
Publications (105)
Introduction
Non-consensual condom removal (“stealthing”) occurs when a perpetrator either says that they will put on a condom but begins intercourse before doing so, or removes a condom before or during intercourse without their partner’s consent. Up to one third of women report experiencing stealthing (Latimer et al., 2018). Stealthing is associa...
Prior research consistently shows disgust propensity and/or state disgust correlated with lower sexual arousal; however, this work has largely excluded women with sexual trauma histories. We tested competing models of the effects of disgust on sexual arousal in women with sexual trauma histories: heightened avoidance of sexual stimuli vs. heightene...
Purpose of Review
Many transgender and gender non-conforming (TGNC) people seek gender-affirming hormone therapy (GAHT). While GAHT is generally safe and increases well-being, it is essential to accurately understand potential unintended effects and risk factors to better inform and manage treatment. This narrative review covers recent literature d...
Experiencing trauma increases risk for posttraumatic stress disorder (PTSD) and depression, and individuals who experience psychopathology after a traumatic event often experience symptoms from both disorders. Because a tendency to view events in a more negative light and a propensity toward threat appraisals are risk factors for both PTSD and depr...
Introduction
There is a complex relationship between women’s sexual functioning and positive outcomes such as satisfaction or pleasure. Some studies indicate that lower physical pleasure mediates the association between sexual function and distress (Stephenson & Metson, 2015), suggesting these constructs are related but distinct. Moreover, differen...
Introduction
Despite calls for greater focus on sex-positive frameworks for understanding adolescent sexuality (Harden, 2014), the majority of research on early puberty and sexual debut has primarily focused on negative outcomes such as body shame (McKenney & Bigler, 2016; Schooler et al., 2005), sexual or vulvar pain (Bergeron et al., 2011; Latthe...
Introduction
“Sexual self-schema" refers to a psychological construct describing the organization of cognitive, affective, and behavioral dimensions of our understanding of ourselves as sexual beings. Sexual self-schema have been shown to mediate a variety of women’s sexual wellbeing outcomes. It is unclear the extent to which existing measurements...
Introduction
The use of recreational substances in a sexual context (sex-linked substance use) is common among young adults, with up to a third indicating that that they used alcohol, cannabis, or both during their recent partnered sexual activity (Willis et al., 2021; Herbenick et al., 2018). Sex-linked substance use (SLSU) is associated with a va...
While most parents and health care providers understand the importance of educating young people about their emerging sexuality, many report never discussing sex with the young people in their care. Using data from a survey of 1,193 emerging adults, we applied concept mapping to a corpus of over 2,350 short qualitative responses to two questions: (...
Purpose of Review
Hormones undeniably play a role in women’s sexual function, but there is much controversy regarding when and how—potentially because psychological effects of hormones depend on social and developmental context. Existing literature documents various health outcomes of sexual trauma and hormonal changes, however, specific mechanisms...
Survivors of unwanted sexual contact have an increased likelihood of using substances in sexual situations, which puts them at heightened risk for intoxication-related harms. Separately, research has indicated that women may intentionally use substances in sexual situations to either enhance pleasure (i.e., increase sexual excitation) and/or reduce...
Although military sexual trauma (MST) is associated with an increased risk of suicide, suicide attempts, and suicidal ideation among service members and veterans, there is limited knowledge regarding the mechanisms of MST and suicidality among men. The current study examined whether MST was associated with sexual compulsivity and/or erectile dysfun...
Introduction
A majority of women who use Selective Serotonin Reuptake Inhibitors (SSRIs) experience iatrogenic sexual dysfunction – primarily decreased arousal and desire (Lorenz et al., 2016). Experiencing SSRI-linked sexual side effects predicts decreased medication satisfaction and adherence, but few psychosocial factors have been identified tha...
Introduction
Hormonal contraceptives (HC) have both nonsexual side effects (e.g, weight gain, headaches, nausea, acne) and sexual side effects (e.g., changes in sexual desire, lubrication, and pleasure) (Smith et al., 2014). Psychosocial factors may contribute to who experiences different kinds of side effect experiences; women reporting mood side...
Objective
To examine the influence of sexual arousal on vaginal mucosal inflammation and antibody production in healthy women with and without histories of childhood and/or adult sexual violence.
Methods
Ninety-one premenopausal healthy women (ages 18 – 42) attended a single laboratory session in which they provided vaginal fluid samples before an...
Despite documented negative sexual health sequelae of unwanted sexual contact (USC), it is unclear why individuals who have experienced USC within the context of intoxication (intoxication-related USC) are at particular risk for poor sexual functioning. Intoxication-related USC may impact relational factors like relationship satisfaction, as trauma...
Background
Inflammation has been linked to a variety of mental and physical health outcomes that disproportionately impact women, and which can impair sexual function; thus, there is reason to expect a link between inflammation and women’s sexual functioning.
Aim
To test the hypothesis that higher concentrations of C-reactive protein (CRP), a gene...
Purpose of Review
Much research has documented changes in postpartum sexuality, including changes in sexual functioning and satisfaction for both the birthing parent and their partner(s). These changes are often linked to postpartum changes in hormonal and immune responses, which can have both direct and indirect effects on sexuality.
Recent Findi...
Background
The presence of a post-traumatic stress disorder (PTSD) diagnosis or higher PTSD severity is associated with higher overall sexual dysfunction in female service members/veterans. However, the mechanisms linking PTSD to specific components of women's sexual arousal function, like lubrication and mental arousal, are unknown.
Methods
We co...
Background
Though many women report sexual arousal difficulties, the mechanisms driving these difficulties are unclear. Sexual response relies on a host of psychophysiological processes that have bidirectional relationships with inflammation. Additionally, chronic inflammation may impair genital blood flow, which in turn may impact sexual arousal....
Sexual self-schema (SSS) – the cognitive frameworks that organize information about one’s own sexuality – are known to guide sexual attitudes and behaviors, and are thus likely to interact with the kinds of people to whom one is attracted (i.e., heterosexual, same-sex/gender, monosexual or bisexual patterns of attraction). Extending prior work high...
Background
Although fingerstick is often favorably compared to venipuncture as a less invasive method of drawing blood for clinical labs, there is little empirical research that compares physical and psychological stress responses to fingerstick vs. venipuncture (blood draw using a needle in the arm) within the same person.
Methods and findings
We...
In this commentary, we argue that feminist science and open science can benefit from each other’s wisdom and critiques in service of creating systems that produce the highest quality science with the maximum potential for improving the lives of women. To do this, we offer a constructive analysis, focusing on common methods used in open science, inc...
Alcohol consumption is on the rise among U.S. women, especially college women, despite the negative consequences that uniquely and disproportionately affect them. The current work integrates objectification theory and related research with literature on drinking motivations to explore how women’s experiences living in a culture that constantly obje...
Background: Bisexual and mostly heterosexual women report higher substance use than exclusively heterosexual or lesbian women. In sexual minority men, sex-linked substance use (SLSU) can increase risk for substance use problems; equivalent research in women is lacking.
Objectives: To test if sexual excitation and inhibition mediate the association...
Purpose:
This study assessed which sexual minority participants selected "Other" if their identity was absent.
Methods:
This was an online survey; 905 participants saw a limited set of sexual orientation options (bisexual, gay/lesbian, heterosexual, other), and later in the same survey, saw an expanded list.
Results:
Twenty-one percent of partici...
Sexual self-schema (SSS) reflect an individual’s cognitive representations of oneself as a sexual person, and predict critical sexual health and wellbeing outcomes in women. Like other cognitive structures, SSS are thought to form through exposure to different kinds of information. The current exploratory study investigated associations between you...
Objective: To compare physical and psychological stress responses to fingerstick vs. venipuncture (blood draw using a needle in the arm) within the same person.Methods: We assessed changes in cortisol (a stress hormone), heart rate variability (a marker of autonomic stress), and psychological stress in 40 healthy women who completed both venipunctu...
We tested the effects of intoxication-related unwanted sexual contact (intoxication-USC) history on heterosexual and sexual minority women’s pleasure during solitary and partnered sexual activity, as well as the indirect effects of sexual excitation and sensation seeking. The impact of intoxication on memory may help explain survivors’ pleasure out...
Purpose of Review
Although healthcare providers are increasingly interested in addressing their female patient’s sexual well-being in a holistic fashion, most do not receive training in how to conceptualize the complex interactions between mind, body, and spirit that drive health and wellness, let alone how to apply empirical data in any of these d...
We tested the effects of intoxication-related unwanted sexual activity (intoxication USA) history on heterosexual and sexual minority women’s pleasure during solo and partnered sexual activity, as well as the indirect effects of relationship satisfaction and emotional closeness during sex. For both sets of models (solo and partnered pleasure), the...
Purpose
To evaluate how sexual pain influences changes in sexual frequency from the pregnancy to postpartum transition, and to examine how couple’s sexual communication interacts with sexual pain during pregnancy.
Methods
We explored data following 159 mixed-sex couples across the transition from pregnancy to 6 months postpartum. Couples completed...
What should we tell our younger clients—who may or may not have chosen to come to therapy—about possible risks of engaging in psychotherapy? To explore this question, we examined psychotherapy side effects in 366 young adults with a history of psychotherapy or counselling. Psychotherapy side effects were common, with 41% of participants reporting a...
A common topic for advice given to parents after childbirth – both from relationship experts and popular media – is how to “bounce back” to one’s pre-pregnancy sexuality, with warnings that postpartum declines in sexual frequency will take a serious toll on one’s relationship. However, these admonishments may not accurately reflect the ways in whic...
Most readers of the Archives of Sexual Behavior will, by now, be familiar with an upsurge of interest in best practices for reproducibility and replicability across modern scientific disciplines (Ioannidis, 2005; National Academies of Sciences Engineering and Medicine, 2019; Simmons, Nelson, & Simonsohn, 2011). Concerns about the basic validity of...
Introduction:
Although antidepressants are well known to cause sexual side effects in adults, the long-term effects of antidepressant use during development on adult sexual function is unknown.
Aim:
To explore differences in sexual desire and sexual behavior between adults who did vs did not use antidepressants during childhood or adolescence....
A common topic for advice given to parents after childbirth – both from relationship experts and popular media – is how to “bounce back” to one’s pre-pregnancy sexuality, with warnings that postpartum declines in sexual frequency will take a serious toll on one’s relationship. However, these admonishments may not accurately reflect the ways in whic...
Purpose of Review
To describe the current state of research on interactions between inflammation and female sexual function.
Recent Findings
Inflammation may interfere with female sexual desire and arousal via direct (neural) and indirect (endocrine, vascular, social/behavioral) pathways. There are significant sex differences in the effect of infl...
Heteronormativity teaches that the only normal way to engage in sexual and romantic relationships is to be heterosexual, often erasing other possibilities. Externally prescribed heteronormativity (the idea that one must be heterosexual, heteroromantic, and monogamous) may contribute to the distress that nonheterosexual individuals experience when q...
Objective:
To assess differences in sexual wellbeing among men and women with exclusively heterosexual, mostly heterosexual, and bisexual attractions.
Method:
An anonymous online survey in a convenience sample of 597 young adults (394 women, 203 men; average age = 20.04) assessed patterns of sexual attraction, desire, sexual functioning, and sex...
Despite common use of antidepressants to treat postpartum depression, little is known about the impact of antidepressant use on postpartum brain activity. Additionally, although oxytocin has been investigated as a potential treatment for postpartum depression, the interaction between antidepressants and exogenous oxytocin on brain activity is unkno...
Although ovarian hormones and social relationships are known to interact with HPA axis regulation, evidence for systematic covariation with basal salivary cortisol levels remains mixed. As part of a larger study, in this analysis we pursued two questions. First, do baseline cortisol concentrations consistently vary across the menstrual cycle? Secon...
Although research has shown interactions between the reproductive system and energy homeostasis, it is not clear how environmental or behavioral factors may factor into these associations. Here we aimed to determine how changes in reproductive state (i.e., phase of the menstrual cycle) and other behavioral and physiological factors may influence le...
Vibrators are an evidence-based treatment for a variety of sexual dysfunctions and sexual enhancement; however, the use of a genital vibrator lacks best practice recommendations. This aim of this article is to provide current, best practice recommendations regarding the use of vibratory stimulation for the treatment of sexual dysfunction and/or sex...
Vibration, as provided by a genital vibrator, is commonly regarded as a tool to enhance sexual pleasure and in modern day society falls under the category of a sex toy. However, the vibrator was not originally intended to be a toy, and its benefits reach far beyond that of a plaything. This article is a narrative review of the current evidence rega...
Past research has found menstrual-cycle-related changes in functional immune response; we examined if sexual activity also changed markers of immune defense. We followed 32 naturally cycling women (15 sexually active with a partner ≥ 1 time/week, 17 sexually abstinent for the last four months) over one menstrual cycle. Participants provided serum a...
There is increasing evidence that activation of the immune system can change behavior and cognition in ways that are though to mitigate disease risk, a phenomenon called “behavioral immunity.” For example, individuals who are in a vulnerable immune state (e.g. pregnancy, recent illness) report significantly higher disgust and avoidance of disease c...
Premenstrual dysphoric disorder (PMDD) remains a controversial diagnosis: Some authors have argued that it pathologizes normal mood changes, and others have questioned the need for daily mood reports across multiple cycles. In the present study, we examined changes in mood among psychologically healthy young participants with regular menstrual cycl...
Objective:
To examine differences in inflammation markers in sexually active versus abstinent women and observe changes in inflammation markers across the menstrual cycle. Cycle-related immune fluctuations may have evolved to reduce interference with conception. If so, reproductively active (i.e., sexually active) women should show the most variab...
Although testosterone (T) has been characterized as universally immunosuppressive across species and sexes, recent ecoimmunology research suggests that T's immunomodulatory effects (enhancing/suppressing) depend on the organism's reproductive context. Very little is known about the immune effects of T in healthy females, and even less about how rep...
Because 1 in 6 women in the United States takes antidepressants and a substantial proportion of patients report some disturbance of sexual function while taking these medications, it is a near certainty that the practicing clinician will need to know how to assess and manage antidepressant-related female sexual dysfunction. Adverse sexual effects c...
This study explored whether basal cortisol concentrations exhibit consistent variations across the menstrual cycle, as well as whether these concentrations differ by relationship status. The Women, Immunity, and Sexual Health (WISH) study gathered four afternoon saliva samples from 14 single and 20 monogamously partnered women. Unexpectedly, saliva...
Symposium presentation reviewing several studies showing significant effect of sexual activity status on variations in immune response across the menstrual cycle in healthy women
Background and objectives:
We examined a mechanism that may coordinate trade-offs between reproduction and immune response in healthy women, namely, changes in inflammation across the ovarian cycle.
Methodology:
We investigated C-reactive protein (CRP), an inflammation marker, across two consecutive ovarian cycles in 61 Bolivian women. Participa...
Several studies have documented shifts in humoral immune parameters (e.g., immunoglobulins) across the menstrual cycle in healthy women. It is thought that these shifts may reflect dynamic balancing between reproduction and pathogen defense, as certain aspects of humoral immunity may disrupt conception and may be temporarily downregulated at ovulat...
Objective:
To investigate if sexual activity moderated menstrual cycle-related shifts in cytokines associated with T-helper type 1 (TH1) cells (e.g., interferon [IFN] γ) and T-helper type 2 (TH2) cells (e.g., interleukin [IL] 4). Immune activity shifts across the menstrual cycle, with higher follicular-phase TH1-cell activity but higher luteal-pha...
Review of research on substance induced sexual dysfunction, including illicit and prescription drugs use in adults and adolescents. Complete chapter to be included in The SAGE Encyclopedia of Abnormal and Clinical Psychology (2016).
Sexual activity modulates shifts in Th1/Th2 cytokine profile across the menstrual cycle: An observational study. Accepted at Fertility & Sterility.
Despite the high prevalence of antidepressant use in women, and recommendations of antidepressants as a first-line therapy for postpartum depression (PPD), remarkably little is known about the impact of antidepressant use on postpartum women’s brain activity. Additionally, although oxytocin has been investigated as a potential therapeutic agent for...
Podium presentation at the annual meeting of the International Society for the Study of Women’s Sexual Health (2015), Austin, TX.
Heart rate variability (HRV) is a measure of autonomic nervous system activity, which reflects an individual's ability to adapt to physiological and environmental changes. Low resting HRV has been linked to several mental health conditions, including depression, anxiety, and alcohol dependence (Kemp et al. in Biological Psychiatry 67(11):1067-1074,...
Study Question: Do variations in inflammation associated with the menstrual cycle depend on women’s reproductive activity?
Summary Answer: Higher frequency of partnered sexual activity predicted greater mid-cycle decrease in inflammation in a sample of healthy premenopausal women.
What is known already: Inflammation varies across the menstrual cy...
Women with histories of childhood sexual abuse (CSA) have higher rates of sexual difficulties, as well as high sympathetic nervous system response to sexual stimuli.
The study aims to examine whether treatment-related changes in autonomic balance, as indexed by heart rate variability (HRV), were associated with changes in sexual arousal and orgasm...
Objective:
This work aims to determine the role of child care in hot flashes. Broad differences in vasomotor symptom experience are observed among perimenopausal women across cultures. Women in cultures where contact with young children is common report significantly fewer and less severe hot flashes than women in cultures where older women spend...
An expressive writing treatment was recently reported to reduce depressive symptoms and improve sexual function and satisfaction in a sample of female survivors of childhood sexual abuse (Meston, Lorenz, & Stephenson, 2013). We conducted a linguistic analysis of this data to determine whether pre- to posttreatment changes in participants’ language...
Abstract Changes in sexual function are a common outcome following risk-reducing salpingo oophorectomy (RRSO), a prophylactic surgery for women at high risk of ovarian and other gynecologic cancers. Despite the known importance of sexuality in patient's quality of life and satisfaction with surgery, little is known about what predicts sexual activi...
Background
In laboratory studies, exercise immediately before sexual stimuli improved sexual arousal of women taking antidepressants [1]. We evaluated if exercise improves sexual desire, orgasm, and global sexual functioning in women experiencing antidepressant-induced sexual side effects. Methods
Fifty-two women who were reporting antidepressant s...
Sudden gains are large reductions in symptoms measured in a single between-session interval and are positively associated with long-term treatment outcomes. To date, sudden gains have mostly been observed in ther- apist-directed psychotherapies. There are currently mixed findings surrounding the mechanisms underlying sudden gains, with some support...
Women with a history of childhood sexual abuse (CSA) have high rates of depression, posttraumatic stress disorder, and sexual problems in adulthood.
We tested an expressive writing-based intervention for its effects on psychopathology, sexual function, satisfaction, and distress in women who have a history of CSA.
Seventy women with CSA histories c...
IntroductionDepression can suppress immune function, leading to lower resistance against infection and longer healing times in depressed individuals. Sexuality may also influence immune function, with evidence that sexual activity is associated with lowered immune function in women and mixed results in men. Immune mediators like immunoglobulin A (I...
Physiological responses to sexual stimuli may contribute to the increased rate of sexual problems seen in women with childhood sexual abuse (CSA) histories. We compared two physiological stress responses as predictors of sexual function and satisfaction, sympathetic nervous system (SNS) activation and cortisol in women with (CSA, N = 136) and witho...
Antidepressants can impair sexual arousal. Exercise increases genital arousal in healthy women, likely due to increasing sympathetic nervous system (SNS) activity.
Test if exercise increases genital arousal in women taking antidepressants, including selective serotonin reuptake inhibitors (SSRIs), which suppress SNS activity, and selective serotoni...
To better understand the link between childhood sexual abuse (CSA) and adult sexual functioning and satisfaction, we examined cognitive differences between women with (N=128) and without (NSA, N=99) CSA histories.
We used the Linguistic Inquiry Word Count, a computerized text analysis program, to investigate language differences between women with...
Past research suggests that sexual satisfaction may be partially dependent on sexual motives (the reasons people have sex). The primary goal of this study was to determine which of a wide range of empirically derived sexual motives were related to sexual satisfaction, and whether gender differences existed in these relationships. Examining data fro...
There is increasing evidence that women's physiological sexual arousal is facilitated by moderate sympathetic nervous system (SNS) activation. Literature also suggests that the level of SNS activation may play a role in the degree to which SNS activity affects sexual arousal. We provide the first empirical examination of a possible curvilinear rela...
Cancers and their treatments are associated with significant sexual dysfunction in both genders [1], but female cancer patients
are significantly less likely than males to seek or receive treatment for their sexual concerns [2]. One study found that
even though the majority of health care providers on oncology teams thought their patients would exp...
Recent research on the impact of religiosity on sexuality has highlighted the role of the individual, and suggests that the effects of religious group and sexual attitudes and fantasy may be mediated through individual differences in spirituality. The present study investigated the role of religion in an ethnically diverse young adult sample (N = 1...