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Case reports on the use of meditative relaxation as an intervention strategy with retarded ejaculation

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Two married males presented with psychogenic retarded ejaculation. Both reported the complete absence of ejaculation during sexual intercourse. Intervention consisted of meditative relaxation exercises together with supportive (brief) psychotherapy--for the husband and wife in both cases. Normal ejaculatory competence was reported by both subjects following 10-12 months of intervention. This was maintained at follow-up 14-16 months later.
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... Bei der Squeeze-Methode soll der Mann über ein "Training" seine Erregung bewußter wahrnehmen. [28,29]. Wirklich kontrollierte Studien bestehen jedoch nicht, sodaß evidenzbasiert keine sicheren Empfehlungen ausgesprochen werden können. ...
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Chapter
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A case of ejaculatory incompetence (inability to ejaculate intravaginally) associated with coital anxiety was resolved in five sessions of behavior therapy. Because it was seen to be mediated by anxiety, the problem was treated by systematic desensitization andin vivo techniques.
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The Cognitive-Somatic Anxiety Questionnaire (CSAQ; Schwartz, Davidson, & Goleman, 1978) is a brief self-report rating scale designed to differentiate between cognitive and somatic symptoms of anxiety. The CSAQ gained relatively widespread acceptance as a behavioral assessment instrument before much was known about its psychometric properties. Psychometric studies of the CSAQ (e.g., DeGood & Tait, 1987) have raised questions about the instrument''s item content and subscale structure. The primary purpose of the present study was to determine whether the Cognitive and Somatic subscales correspond to the instrument''s factorial structure in a clinically anxious population. The sample consisted of 120 nonpsychotic psychiatric inpatients. Factor analysis with oblique rotation accounted for 60% of the total variance and yielded four factors that do not conform to the Cognitive-Somatic subscale structure. The results challenge the validity of the CSAQ and suggest the need for an improved instrument capable of differentiating the multidimensional features of clinical anxiety.
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Retarded ejaculation is the persistent difficulty or inability to ejaculate despite the presence of adequate sexual desire, erection, and stimulation. The causes of this dysfunction may be organic, i.e., medical illness or drug ingestion (particularly medications with antiadrenergic effects), the result of surgical interventions, or secondary to inhibiting psychological factors. With regard to psychological determinants, fear, guilt, resentment, and passively have all been implicated, although objective studies are rare. The sexual object choice of men with retarded ejaculation has ben reported by several clinicians and investigators to be other than adult members of the opposite sex, while the marital relationship of these males has been considered etiological in other instances. Outcome assessment to date consists mostly of individual case reports or reports on small groups of patients treated without controls. To some extent, routine reliance on long-term traditional therapy has yielded to shorter, symptomatic learning-based treatments. While improved outcomes have been reported, many patients do not respond well. It is not yet possible to objectively predict succes or failure. Since it is our impression that this sexual dysfunction is more common than previously assumed (or is increasing in frequency), our present lack of data should soon be remedied.