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A structured review of the utility of the Arizona Sexual Experiences Scale (ASEX)

Authors:

Abstract

Epidemiological studies indicate that approximately 40% of women and 30% of men report sexual difficulties but recognition in medical settings is sub-optimal, possibly due to problems in describing and eliciting concerns relating to sexual function (Baldwin et al 2015). Screening questionnaires may help to support this aspect of clinical practice (Rizvi et al 2011). The Arizona Sexual Experiences Scale (ASEX) (McGahuey et al 2000) includes items that quantify sex drive, arousal, vaginal lubrication/penile erection, ability to reach orgasm and satisfaction from orgasm. Although frequently used, its psychometric properties outside of North American populations and its utility in routine clinical settings are both uncertain. The ASEX appears to be a reliable clinical instrument for identifying and quantifying sexual dysfunction across a range of populations in various clinical settings. Little is known about either the utility of ASEX in patients with anxiety disorders or possible relationships between ASEX scores and potential biological markers.
JOURNAL OF PSYCHOPHARMACOLOGY
SUPPLEMENT TO ISSUE 33, NUMBER 8, AUGUST 2019
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A78 ABSTRACTS
measures were used to predict changes on the primary outcome well-being (WEMWBS). Psychological trait
variables anxiety (STAI-SF), absorption (MODTAS), and suggestibility (SSS), state variables measuring set
(PPS) and identity fusion, and items on intentions and environmental setting elements were used to predict
the acute subjective experience in separate GLMs.
Results: The main outcome, psychological well-being, was elevated two and four weeks after the
experience when compared to baseline (p < .001, η2 = .399). This increase in well-being was more
pronounced for individuals who had stronger ‘communitas’ (beta = 3.26, p = .038) and ‘emotional
breakthrough’ experiences (beta = 5.80, p = .01) during the session. A positive mindset immediately before
the experience and the perceived impact of ‘supportive individuals’ were positively associated with
emotional breakthroughs (p = .049, η2 =.093; p = .019, η2 = 0.79, respectively)
Conclusions: These results demonstrate the importance of sucient preparation and emotional support
in guided psychedelic experiences, as well as the capacity of environmental elements to shape responses.
Challenging emotional processes mediated positive long-term change, putting into question the dichotomy
between harmful challenging and benecial mystical-type experiences. Anthropologically relevant
intersubjective phenomena such as communitas may bear therapeutic relevance and should be considered
in future research on psychedelic group experiences. This rst quantitative examination of psycho-social
and environmental factors in guided psychedelic settings is a signicant step towards evidence-based
guidelines for psychological harm-reduction and benet-maximisation.
Funding: No funding was required for this research.
C05
EVALUATION OF THE UTILITY OF THE ASEX SCALE FOR ASSESSING SEXUAL DYSFUNCTION
Elnazer HY, University Dept of Psychiatry, University of Southampton, Academic Centre, College Keep, 4-12
Terminus Terrace, Southampton, SO14 3DT hye1c13@soton.ac.uk
Baldwin DS(1)
(1) Professor of Psychiatry and Head of Mental Health Group, University of Southampton, Faculty of
Medicine
Introduction: Epidemiological studies indicate that approximately 40% of women and 30% of men report
sexual diculties. Recognition of sexual diculties is sub-optimal, possibly due to diculties in describing
and eliciting problems relating to sexual function. Screening questionnaires may help to support this
aspect of clinical practice. The Arizona Sexual Experiences Scale (ASEX) includes items that quantify sex
drive, arousal, vaginal lubrication/penile erection, ability to reach orgasm, and satisfaction from orgasm.
Total scores range between 5-30, higher scores indicating more severe diculties. Although frequently
used, its psychometric properties outside of North American populations and its utility in routine clinic
settings are both uncertain..
Methods: We searched MEDLINE and EMBASE for articles published to March 2018, using the terms,
Arizona Sexual Experiences Scale, Arizona Sexual Experience Questionnaire and ASEX. We then
eliminated duplications, letters and papers not available in English. We grouped remaining papers into the
three categories of validation, epidemiological, and outcome-based studies.
Results: We identied 236 records, 224 were screened, after excluding letters and duplicates. 219 were
assessed for eligibility after 5 were excluded as not in English. 49 pre-clinical studies were excluded and
70 were excluded furthermore as were not obtainable or not specically related to the subject. 100 papers
were included. Cronbach’s alpha analysis indicated that the ASEX had excellent internal consistency and
scale reliability (α=0.9055) and strong test-retest reliability (for patients, r=0.801, p<0.01; for controls,
r=0.892, p<0.01). Analyses of variance (ANOVAs) revealed signicant differences in total ASEX scores
between patients and controls (for males F=18.1, p<0.000; for females F=31.71, p<0.000) and between
females and males (for patients F=5.22, p=0.026; for controls F=5.05, p=0.031). ASEX appears useful in a
range of clinical situations including patients with primary sexual dysfunction (n=7), specic psychiatric
disorders (n=9), specic physical illnesses (n=44) and treatment-emergent sexual dysfunction (n=42).
Higher ASEX scores in populations with treatment-emergent dysfunction are associated with the 5-HT2A
receptor -1438 AA genotype, and CYP2D6 poor metabolic status phenotype (n=2) in female patients.
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