Content uploaded by David de Jong
Author content
All content in this area was uploaded by David de Jong on Jan 05, 2015
Content may be subject to copyright.
A preview of the PDF is not available
The Role of Attention in Sexual Arousal: Implications for Treatment of Sexual Dysfunction
Abstract
The literature on the role of attention in sexual arousal is reviewed, especially that which has implications for noninvasive treatment of sexual dysfunction. Findings suggest that voluntary control of sexual arousal can be achieved through attentional focus on nonsexual cognitions or sexual fantasy. Cognitive biases may direct attention and thus facilitate or impede sexual arousal. Sexual arousal may be influenced by directed attentional focus, and preliminary evidence suggests that mindfulness techniques may result in longer-term changes in attentional focus; these changes, in turn, may improve sexual response. Information-processing models of sexual arousal developed in light of such findings are discussed. This research establishes the central role of attentional processes in facilitating physiological and, especially, subjective sexual arousal. Implementing approaches that capitalize on attentional processes could advance noninvasive treatment of sexual dysfunction. Future avenues of research might investigate how play, mammalian play circuits, and flow states are relevant to sexual response and satisfaction.
... To date, the relationship between body image and sexual function has been primarily evaluated in the context of cognitive distraction. It is well-established that the arousal process (e.g., penile erection, vaginal lubrication, etc.) is supported by parasympathetic nervous system dominance, and high levels of anxiety can interfere with this process, even when sexual interest/desire is present [104,105]. For men, anxiety often manifests as concerns related to sexual performance, such as the ability to get and maintain an erection or to ensure their partner reaches orgasm [106]. ...
Purpose of review:
Sexual dysfunction is commonly associated with overweight/obesity, but the underlying physiological and psychosocial mechanisms are not fully understood. This review contextualizes the obesity-sexual (dys)function relationship, describes recent insights from the medical and social science literature, and suggests opportunities for continued research.
Recent findings:
Although sexual dysfunction has been historically evaluated as a consequence/outcome of obesity, it is increasingly considered as a harbinger of future metabolic comorbidities, including type 2 diabetes and cardiovascular disease. Body image dissatisfaction is a consistent predictor for lower sexual satisfaction across BMI categories, likely mediated by cognitive distraction during partnered sex. To fully capture the relationship between obesity and sexual dysfunction, multidisciplinary research approaches are warranted. While clinically significant weight loss tends to improve sexual functioning for women and men, higher body image satisfaction may independently promote sexual function and satisfaction without concomitant weight loss.
... In comparison to fathers, who do not report their multitasking to be a negative experience, mothers experience these additional hours negatively, reporting associations with work-family conflict, stress, difficult emotions, and psychological distress (Offer & Schneider, 2011). Interestingly, some evidence-based treatments for low sexual desire and reduced sexual satisfaction posit that some of the difficulty women report in sex may be related to difficulty concentrating on the sexual experience (De Jong, 2009). With all the burden of mental labor that needs to occur and not enough hours in the day, it may be that women have difficulty turning off the "multi-tasking" while having sex. ...
As academic mothers of children with disabilities, the authors are stretched between our roles as scholar, teacher, mentor, parent, caregiver, advocate, and partner (Good et al., 2017). In this chapter, the authors draw on personal and professional experiences to discuss the benefits and barriers to an academic career while simultaneously parenting disabled children, with a specific focus on how social media, through a private Facebook group, has provided support. Within the community, the members find connections, resources, and peer-to-peer mentoring, which remain scarce to nonexistent in the authors’ personal and professional communities, largely due to implicit ableism. While academics sometimes define success as intellectual vitality, academic parents of children with disabilities may have different definitions of success. The gap between conventional academic measures of success and our revised assessments exacerbates maternal stress and professional pressures as the authors pursue work-life fit.KeywordsDisabilityInformal supportBoundary-settingAffinity groups
... Additionally, cognitive distractors have been indicated as a strong predictor of problems with genital reactions among women. 49,81 Therefore, it seems that the ability to focus on "here and now" and on body sensations may contribute to improving women's sexual response in the form of lubrication. Similar conclusions apply to the orgasm and KSS domains, with the nonreactivity dimension correlated. ...
Background:
Mindfulness-based therapies (MBTs) are frequently used in the treatment of sexual dysfunctions. So far, there has not been sufficient evidence for the effectiveness of interventions based on mindfulness monotherapy.
Aim:
The aim of the study was to assess the effect of mindfulness monotherapy on the reduction of sexual dysfunction symptoms and sex-related quality of life.
Methods:
We conducted 4 weeks of MBT for 2 groups of heterosexual females: 1 with psychogenic sexual dysfunction (WSD) and 1 with no sexual dysfunction (NSD). Overall 93 women were recruited for the study. We collected data via an online survey regarding sexual satisfaction, sexual dysfunctions, and mindfulness-related features at baseline, 1 week after MBT, and follow-up 12 weeks after MBT. Research tools included the Female Sexual Function Index, Five Facet Mindfulness Questionnaire, and Sexual Satisfaction Questionnaire.
Outcomes:
Participating in the mindfulness program had a positive effect on women with and without sexual dysfunction.
Results:
The overall risk for sexual dysfunction decreased from 90.6% at baseline to 46.7% at follow-up in the WSD group and from 32.5% at baseline to 6.9% at follow-up in the NSD group. Participants in the WSD group reported a significant increase in levels of sexual desire, arousal, lubrication, and orgasm between measurements, although not in the pain domain. Participants in the NSD group reported a significant increase in the level of sexual desire between measurements but not in levels of arousal, lubrication, orgasm, and pain. A significant increase in sex-related quality of life was observed in both groups.
Clinical implications:
The results of the study have a chance to translate into an introduction of a new therapeutic program for specialists and more effective help offered to women experiencing sexual dysfunctions.
Strengths and limitations:
This mindfulness monotherapy research project, which included assessment of meditation "homework," is the first to verify the potential of MBT in reducing symptoms of psychogenic sexual dysfunctions among heterosexual females. Major limitations include the lack of randomization, an adequate control group, and a validated measure of sexual distress.
Conclusion:
The applied training was beneficial in the treatment of sexual dysfunctions in terms of increasing desire and arousal as well as the ability to reach orgasm. However, this approach needs more investigation before it can be recommended in the treatment of sexual dysfunction. The study should be replicated under a more rigorous research design, including adequate control groups and random allocation of participants to study conditions.
... The former refers to the experience of sexual attraction and feelings (e.g. pleasure) toward sexual stimuli and erotic cues and awareness of physiological sexual arousal [25,26], and the latter to physiological responses, which includes changes in cardiovascular, respiratory and genital tissues, including vaginal vasocongestion and lubrication in women, and penile erection in men [17,27]. The interaction of both subjective and physical sexual arousal can lead to approach or avoidance of a sexual stimulus and sexual behavior [28]. ...
Visual attention plays a central role in current theories of sexual information processing and is key to informing the use of eye-tracking techniques in the study of typical sexual preferences and more recently, in the study of atypical preferences such as pedophilia (prepubescent children) and hebephilia (pubescent children). The aim of this theoretical-empirical review is to connect the concepts of a visual attention-based model of sexual arousal processing with eye movements as indicators of atypical sexual interests, to substantiate the use of eye-tracking as a useful indirect measure of sexual preferences according to sex and age of the stimuli. Implications for research are discussed in terms of recognizing the value, scope and limitations of eye-tracking in the study of pedophilia and other chronophilias in males and females, and the generation of new hypotheses using this type of indirect measure of human sexual response.
Lay summary
Eye tracking has recently been applied as a technique to measure indicators of atypical sexual interests such as pedohebephilia. This review seeks to outline the theoretical-empirical rationale to support the responsible use of the technique and to delineate its current impact and scope in understanding pedophilia, hebephilia, and other chronophilias.
... Sexual arousal is divided into subjective and physiological arousal [1]. Subjective arousal is the emotional experience that includes the awareness of self-arousal, expected feedback, and stimulated desire. ...
Purpose: To provide more information about blind men for the study of andrology by characterizing their current sexual behavior.
Methods: A questionnaire-based cross-sectional study design was used, including questions on demographic characteristics of participants, access to sexual knowledge, perception of the sexual partners' beauty, and sexual arousal.Blind men were interviewed face-to-face by the trained investigator.
Results: A total of 54 participants returned a completed survey with average age of 40.57 ± 9.80 years old. Their sexual orientation were all heterosexual. 90.7% of the participants have had sexual experience. Only 16.7% of the participants have received sex education. Access to sexual knowledge was mainly through sounds from mobile phones, peer to peer communication, sounds of television and radio. Voice was the most frequent perception of the sexual partners' beauty, followed by figure, skin, and body fragrance. The results on the stimuli of sexual arousal showed that tactile sensation and auditory sensation in that order were the most frequent stimuli of sexual arousal.
Conclusion: The stimuli of sexual arousal in blind men are mainly mediated by sound and touch. Blind men understand their sexual partners' beauty through auditory, tactile, and olfactory sensation. Blind men in Ganzhou lack formal and systematic sex education.
It has been reported that individuals with psychogenic erectile dysfunction (pED) potentially suffer from cognitive declines. Despite that increasing neuroimaging studies have demonstrated abnormalities of cerebral structural changes in pED, the association between altered white matter (WM) structural network and cognitive impairments remains unclear. Hence, this study aimed to explore the relationship between WM structural network connectivity and cognitive performance in patients with pED. Forty pED patients and 33 healthy controls (HCs) were recruited to perform cognitive assessments, and diffusion tensor imaging scans. We firstly constructed the WM structural network and applied the machine learning method to identify the important features. Then, we examined group differences in cognitive assessments, WM structural network connectivity within the identified features, and associations between altered WM structural network connectivity and cognitive scores in pED patients. From 26896 features of DTI data, 24 important features were identified by K-Nearest Neighbor classification with a satisfactory accuracy (78%). Compared with HCs, we found that pED patients showed higher fractional anisotropy (FA) values between left transverse temporal sulcus and left supramarginal gyrus, and lower FA values between left suborbital sulcus and left para-hippocampal part of the medial occipito-temporal gyrus in pED patients. Furthermore, the increased FA between left transverse temporal sulcus and left supramarginal gyrus was observed to be negatively associated with impaired delayed memory. Overall, our findings provide new insights into WM network alterations associated with impaired cognitive functions in pED, which may unravel the potential neural mechanisms underlying the cognitive impairments of pED patients.
Considered a fundamental aspect of well-being and health, sexuality is an important contributor to quality of life and relationship well-being. Transition to motherhood can all have significant impacts on sexuality with rates of sexual dysfunction increases five-fold following childbirth. Additionally, for mothers who are employed in high powered careers, such as academia, challenges in maintaining work-life balance and managing job stress can also impact sexual function. Sexual education is historically poor in helping prepare people for resilience in the face of sexual challenges that accompany life changes, health events, and aging. Access to sexuality resources is also difficult, with conversations about sexuality rarely taking place between health care providers and patients. The stigma that accompanies discussion of sexuality leaves many mothers isolated in their suffering. Very little support exists to help women challenge the social pressures to maintain “it all”: being a good mother, having a thriving academic career, maintaining an excellent relationship, and being “sexy” while doing it. Private online groups can provide support on vulnerable topics associated with motherhood and provide appropriate support for women experiencing sexual difficulty. Through a series of case examples exploring the importance of pelvic floor physical therapy, normalizing changes in sexual desire, and addressing sexual pain, this chapter explores how online communities can support mothers experiencing sexual concerns.KeywordsPostpartumSexualitySexual dysfunctionSocial support
Increasing neuroimaging studies have demonstrated abnormalities of cerebral structural changes in psychogenic erectile dysfunction (pED). Despite the abnormal brain changes involving cognitive processing in pED, pED patients suffer from cognitive dysfunction by screening in standard neurocognitive tests remain elusive. This study aimed to explore the alterations of structural brain networks associated with cognitive impairments in pED. We firstly used different machine learning methods to probe discriminative brain maps between 40 pED patients and 33 healthy controls (HCs) for diffusion tensor imaging (DTI) data. Then, we identified the important features of pED patients to analyze the abnormal structural brain networks in association with cognitive functions compared to HCs. From 26896 features of DTI data, 24 important features were identified by K-Nearest Neighbor classification with a satisfactory accuracy (78%). According to the results of the machine learning analysis, we found that pED patients showed higher FA values between left transverse temporal sulcus and left supramarginal gyrus ( p = 0.001, Bonferroni corrected), and lower FA values between left suborbital sulcus and left para-hippocampal part of the medial occipito-temporal gyrus in ED patients than HCs ( p < 0.001, Bonferroni corrected). Furthermore, the increased FA between left transverse temporal sulcus and left supramarginal gyrus was observed to be negatively associated with erectile dysfunction ( p < 0.001) and impaired delayed memory (p = 0.028). Overall, our findings provide new insights into white matter network alterations associated with impaired cognitive functions in pED, which may provide a potential biomarker for treating pED.
Female sexual dysfunction (FSD) is a common disease that affects many women, and there are few therapeutic options available. Female sexual dysfunction is a progressive and prevalent illness that affects more women as they get older. Reduced vaginal lubrication, soreness and discomfort during intercourse, a decreased sense of excitement, and difficulties achieving orgasm are all common signs of female sexual dysfunction. Only a small percentage of women seek medical help. In comparison to the vast amount of study and treatment for erectile dysfunction in men, female sexual dysfunction has received far less attention, with treatment mostly consisting of psychological therapy. The aim of the chapter is to provide the most current knowledge on female sexual dysfunction, advances in basic science addressing this dysfunction, and explore developing therapeutic options.
How can we get the most out of our close relationships? Research in the area of personal relationships continues to grow, but most prior work has emphasized how to overcome negative aspects. This volume demonstrates that a good relationship is more than simply the absence of a bad relationship, and that establishing and maintaining optimal relationships entails enacting a set of processes that are distinct from merely avoiding negative or harmful behaviors. Drawing on recent relationship science to explore issues such as intimacy, attachment, passion, sacrifice, and compassionate goals, the essays in this volume emphasize the positive features that allow relationships to flourish. In doing so, they integrate several theoretical perspectives, concepts, and mechanisms that produce optimal relationships. The volume also includes a section on intensive and abbreviated interventions that have been empirically validated to be effective in promoting the positive features of close relationships.
The dopaminergic modulation of neural activity in the prefrontal cortex (PFC) is essential for working memory. Delay-activity in the PFC in working memory tasks persists even if interfering stimuli intervene between the presentation of the sample and the target stimulus. Here, the hypothesis is put forward that the functional role of dopamine in working memory processing is to stabilize active neural representations in the PFC network and thereby to protect goal-related delay-activity against interfering stimuli. To test this hypothesis, we examined the reported dopamine-induced changes in several biophysical properties of PFC neurons to determine whether they could fulfill this function. An attractor network model consisting of model neurons was devised in which the empirically observed effects of dopamine on synaptic and voltage-gated membrane conductances could be represented in a biophysically realistic manner. In the model, the dopamine-induced enhancement of the persistent Na ⁺ and reduction of the slowly inactivating K ⁺ current increased firing of the delay-active neurons, thereby increasing inhibitory feedback and thus reducing activity of the “background” neurons. Furthermore, the dopamine-induced reduction of EPSP sizes and a dendritic Ca ²⁺ current diminished the impact of intervening stimuli on current network activity. In this manner, dopaminergic effects indeed acted to stabilize current delay-activity. Working memory deficits observed after supranormal D1-receptor stimulation could also be explained within this framework. Thus, the model offers a mechanistic explanation for the behavioral deficits observed after blockade or after supranormal stimulation of dopamine receptors in the PFC and, in addition, makes some specific empirical predictions.
In this article we propose an emotion perspective on the study of sexual experience. First we discuss the contents of experience, which are based on three sources of information: the environment or situation being appraised, autonomic response, and both readiness for and feedback from behavioral response. Then we describe a working memory model to help explain how the experience of sexual emotions is constructed. Finally, we illustrate the application of an emotion perspective through discussion of gender differences in the processing of sexual information and through psychophysiological studies on sexual response.
The need for models of optimal sexuality in sex therapy and the lack of theoretical and especially empirical foundations are discussed. Specifically, what lessons can be gleaned from those who seek and attain extraordinary sexual relations? As a preliminary part of a study of optimal sexuality, individuals who report having had “great sex” were interviewed. The six major themes emerging from the initial 50 hours are described. These are conceptualized as building blocks toward the farther reaches of human erotic potential and consist of being present, authenticity, intense emotional connection, sexual and erotic intimacy, communication, and transcendence. Clinical implications of these findings are discussed. The need for sex therapists to acquire and transmit new methods and skills is considered.
Mindfulness practice is an ancient tradition in Eastern philosophy that forms the basis for meditation, and it is increasingly making its way into Western approaches to health care. Although it has been applied to the treatment of many different mental health disorders, it has not been discussed in the context of therapy for sexual problems. In a previous qualitative study of female meditation practitioners who did not have sexual concerns, mindfulness practice was found to be associated with greater sexual response and higher levels of sexual satisfaction. We have recently developed a psychoeducational program for women with sexual arousal disorder subsequent to gynecologic cancer and have included a component of mindfulness training in the intervention. In this paper, we will attempt to provide a rationale for the use of mindfulness in the treatment of women with sexual problems, and will include transcript excerpts from women who participated in our research trial that illustrate how mindfulness was effective in improving their sexuality and quality of life. Although these findings are preliminary, they suggest that mindfulness may have a place in the treatment of sexual concerns.
A model of sexual arousal is presented that highlights the interaction between automatic and controlled cognitive processes and proposes that different levels of cognitive processing can differentially affect subjective and physiological sexual arousal. In addition, two studies are presented in which the role of automatic processes was explored using a priming paradigm. Subjects were sexually functional men. In the first study an effect of priming was found on penile erection. Unexpectedly, responses were lower in sexual than in neutral trials. In the second study support was found, using a behavioral measure (decision time), for the notion that the meaning of sexual stimuli can be perceived in a fast, automatic manner. Priming was most successful at lower levels of stimulus accessibility. The model and experimental approach presented in this article render starting points for new research on response discordance, gender differences in the processing of sexual stimuli, and inhibition of sexual response.
