Article

Vaginal Orgasm Is Associated with Less Use of Immature Psychological Defense Mechanisms

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Abstract

Freud implied a link between inability to have a vaginal orgasm and psychosexual immaturity. Since Kinsey, many sexologists have asserted that no such link exists. However, empirical testing of the issue has been lacking. The objective was to determine the relationship between different sexual behavior triggers of female orgasm and use of immature psychological defense mechanisms. Women reported their past month frequency of different sexual behaviors and corresponding orgasm rates and completed the Defense Style Questionnaire (DSQ-40). The association between ability to have vaginal intercourse orgasm (versus clitoral orgasm) and the use of DSQ-40 immature psychological defense mechanisms (associated with various psychopathologies) was examined. In a sample of 94 healthy Portuguese women, vaginal orgasm (triggered solely by penile-vaginal intercourse) was associated with less use of DSQ-40 immature defenses. Vaginal orgasm was associated with less somatization, dissociation, displacement, autistic fantasy, devaluation, and isolation of affect. Orgasm from clitoral stimulation or combined clitoral-intercourse stimulation was not associated with less use of immature defenses, and was associated with more use of some immature defenses. In one regression analysis, more masturbation and less vaginal orgasm consistency made independent contributions to the statistical prediction of immature defenses. In another regression analysis, any use of extrinsic clitoral stimulation for intercourse orgasm, and lack of any vaginal orgasm, made independent contributions to the statistical prediction of immature defenses. Vaginally anorgasmic women had immature defenses scores comparable to those of established (depression, social anxiety disorder, panic disorder, and obsessive-compulsive disorder) outpatient psychiatric groups. Results were not confounded by social desirability responding or relationship quality. The results linking penile-vaginal orgasm with less use of immature psychological defense mechanisms are consistent with both early psychoanalytic personality theory and recent advances in sexual physiology. Implications for diagnosis and sex therapy are noted.

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... Participants reported their past month frequency (days) of PVI, orgasm during PVI without direct clitoral stimulation, orgasm during PVI with direct clitoral stimulation, non-coital partnered sex (without same-day PVI), non-coital partnered sex orgasm (regardless of same-day PVI), masturbation, and masturbation orgasm [5]. ...
... Because the frequency of some different partnered sexual behaviors tend to intercorrelate, sometimes their ultimate differential relationships with a given variable may become obscured by intercorrelations (such as those due to a non-coital activity being foreplay to PVI), unless multivariate analyses with several sexual behaviors as independent variables are used to disentangle the specific relationships [5,6,[17][18][19]. This procedure has previously revealed a more consistent cross-cultural confirmation that PVI and vaginal orgasm are the sexual activities most consistently related to better health, better relationship satisfaction, and greater sexual satisfaction [5,17]. ...
... Because the frequency of some different partnered sexual behaviors tend to intercorrelate, sometimes their ultimate differential relationships with a given variable may become obscured by intercorrelations (such as those due to a non-coital activity being foreplay to PVI), unless multivariate analyses with several sexual behaviors as independent variables are used to disentangle the specific relationships [5,6,[17][18][19]. This procedure has previously revealed a more consistent cross-cultural confirmation that PVI and vaginal orgasm are the sexual activities most consistently related to better health, better relationship satisfaction, and greater sexual satisfaction [5,17]. Thus, multiple regressions (using the backward exclusion method to provide a good balance of stability and statistical power) were conducted with waist circumference as the dependent variable, and the frequencies of the various orgasm triggers, age, social desirability responding, relationship status, and cohabitation, as independent variables. ...
Article
Objective: Given that adiposity is related to poorer female sexual function, among many other health problems, the present study aimed at testing the hypothesis that larger waist circumference, an index of subcutaneous and abdominal fat mass, is associated with lack of specifically vaginal orgasm. Study design One hundred and twenty Portuguese women of reproductive age had their waist measured and reported their past month frequency of penile-vaginal intercourse (PVI), vaginal orgasm, orgasm from clitoral masturbation during PVI, non-coital partnered sex (in the absence of same-day PVI), non-coital partnered sex orgasm (regardless of same-day PVI), masturbation, and masturbation orgasm. Results: In both simple and partial correlations (controlling for age, social desirability responding, relationship status, and cohabitation status), larger waist circumference was associated with lack of any vaginal orgasm and with having masturbated in the past month. In a multiple regression, larger waist circumference was independently predicted by lesser frequency of vaginal orgasm, greater frequency of masturbation, and older age. Conclusion: Abdominal fat mass appears to be adversely associated with lesser capacity for vaginal orgasm, but not for orgasms from other sexual activities. Results are discussed in the context of vaginal orgasm being relatively more contingent on situations of increased fitness in both partners.
... Similar results were obtained for studies of orgasm triggers: orgasm triggered directly by PVI per se (in the case of women, this is termed vaginal orgasm) was associated positively with satisfaction measures and other indices of favorable psychological and psychophysiological function [1,3,6,[10][11][12][13][14][15][16][17][18][19]. For example, postorgasmic prolactin increases after intercourse are strongly associated with women's assessment of orgasm quality and women's subsequent sexual satisfaction [20], and for both sexes, the postorgasmic prolactin increases following PVI orgasm are severalfold greater than following masturbation [21]. ...
... The sample size has more than 80% statistical power to detect a correlation of 0.37 (the medium-to-large effect size correlation obtained between VOC and a personality trait reported in a JSM study [12]). SPSS for Windows version 13.0 (SPSS, Inc., Chicago, IL, USA) was used for analyses. ...
... Men's discernment of VOC being associated with women's better dyadic adjustment might be explained at least in part by better relationship functioning including the aspects (measured by the scale) of cohesion, affectional expression, and dyadic consensus, which can lead to greater empathy between partners and thus lower percentage of faking orgasms by the woman. Men's ability to discern VOC could be an advantageous trait that contributes to women's relationship and sexual satisfaction, in addition to VOC itself, PVI frequency, and male partner physical traits including male attractiveness, masculinity, and penis length [15,25,27,35,[38][39][40]. In addition, given that VOC is associated with aspects of women's fitness [1,11,12,18,26,41], men's discernment of VOC provides him with information on partner fitness as well. ...
Article
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IntroductionResearch indicated that (i) vaginal orgasm consistency is associated with indices of psychological, intimate relationship, and physiological functioning, and (ii) masturbation is adversely associated with some such measures.AimThe aim of this study was to examine the association of various dyadic and masturbation behavior frequencies and percentage of female orgasms during these activities with: (i) measures of dyadic adjustment; (ii) sexual satisfaction; and (iii) compatibility perceived by both partners.Methods In a sample of 85 Czech long-term couples (aged 20–40; mean relationship length 5.4 years), both partners provided details of recent sexual behaviors and completed sexual satisfaction, Spanier dyadic adjustment, and Hurlbert sexual compatibility measures. Multiple regression analyses were used.Main Outcome MeasureThe association of sexual behaviors with dyadic adjustment, sexual compatibility, and satisfaction was analyzed.ResultsIn multivariate analyses, women's dyadic adjustment is independently predicted by greater vaginal orgasm consistency and lower frequency of women's masturbation. For both sexes, sexual compatibility was independently predicted by higher frequency of penile–vaginal intercourse and greater vaginal orgasm consistency. Women's sexual satisfaction score was significantly predicted by greater vaginal orgasm consistency, frequency of partner genital stimulation, and negatively with masturbation. Men's sexual satisfaction score was significantly predicted by greater intercourse frequency and any vaginal orgasm of their female partners. Concordance of partner vaginal orgasm consistency estimates was associated with greater dyadic adjustment.Conclusions The findings suggest that specifically penile–vaginal intercourse frequency and vaginal orgasm consistency are associated with indices of greater intimate relationship adjustment, satisfaction, and compatibility of both partners, and that women's masturbation is independently inversely associated with measures of dyadic and personal function. Results are discussed in light of previous research and an evolutionary theory of vaginal orgasm. Klapilová K, Brody S, Krejčová L, Husárová B, and Binter J. Sexual satisfaction, sexual compatibility, and relationship adjustment in couples: The role of sexual behaviors, orgasm, and men's discernment of women's intercourse orgasm. J Sex Med **;**:**–**.
... Notably, greater likelihood of orgasm from PVI, or more specifically vaginal orgasm (orgasm elicited solely by penile-vaginal stimulation without clitoral masturbation; measured in research studies either dichotomously as ever having a vaginal orgasm, or dimensionally as vaginal orgasm consistency [VOC], the percentage of PVI occasions resulting in vaginal orgasm) is associated with physiological and self-perceived sexual functioning within women. Differences have been observed for measures including: greater tactile sensitivity [8], higher heart rate variability (an index of parasympathetic tone relevant to emotional function, attention, and life expectancy) [9], greater concordance of vaginal and subjective indices of sexual arousal [10,11], less functional pelvic musculoskeletal blockage [12], lower likelihood of developing female sexual arousal disorder [13], greater satisfaction with sex life and other aspects of life [14][15][16], emotional regulation [8,17,18], and intimate relationship function [7,19]. ...
... However, three of them chose not to complete the questionnaires and were thus excluded from the analyses. A sample size of 75 has over 80% statistical power [27] to detect a correlation of 0.37 (the medium to large effect size correlation obtained between VOC and a personality trait reported in a Journal of Sexual Medicine study; [17]). ...
... Our results also indicate that deep vaginal sexual arousability is associated with sexual arousability at the other vaginal sites, but not the clitoris (implying differential activation). These results are consistent with the brain imaging differences noted by Komisaruk et al. [2], as well as clinical differences between vaginal orgasm and clitoral orgasm [4,8,9,17,19,33]. Our finding that sexual arousability during stimulation of the shallow vagina was associated with sexual arousability during stimulation of the three other genital sites is consistent with the findings of Komisaruk et al. [2] but also not inconsistent with the finding of Buisson et al. [30,31] because of the correlation we observed between shallow vaginal and clitoral arousability. ...
Article
Full-text available
Introduction: Research indicated that: (i) vaginal orgasm (induced by penile-vaginal intercourse [PVI] without concurrent clitoral masturbation) consistency (vaginal orgasm consistency [VOC]; percentage of PVI occasions resulting in vaginal orgasm) is associated with mental attention to vaginal sensations during PVI, preference for a longer penis, and indices of psychological and physiological functioning, and (ii) clitoral, distal vaginal, and deep vaginal/cervical stimulation project via different peripheral nerves to different brain regions. Aims: The aim of this study is to examine the association of VOC with: (i) sexual arousability perceived from deep vaginal stimulation (compared with middle and shallow vaginal stimulation and clitoral stimulation), and (ii) whether vaginal stimulation was present during the woman's first masturbation. Methods: A sample of 75 Czech women (aged 18-36), provided details of recent VOC, site of genital stimulation during first masturbation, and their recent sexual arousability from the four genital sites. Main outcome measures: The association of VOC with: (i) sexual arousability perceived from the four genital sites and (ii) involvement of vaginal stimulation in first-ever masturbation. Results: VOC was associated with greater sexual arousability from deep vaginal stimulation but not with sexual arousability from other genital sites. VOC was also associated with women's first masturbation incorporating (or being exclusively) vaginal stimulation. Conclusions: The findings suggest (i) stimulating the vagina during early life masturbation might indicate individual readiness for developing greater vaginal responsiveness, leading to adult greater VOC, and (ii) current sensitivity of deep vaginal and cervical regions is associated with VOC, which might be due to some combination of different neurophysiological projections of the deep regions and their greater responsiveness to penile stimulation.
... A recent ardent supporter of this 'undermining healthy femininity' concept is Brody S [8] and a small coterie of coworkers who claim that clitoral stimulation in women leading to induction of orgasm is not beneficial to their physical, psychological, interpersonal or behavioural health. Furthermore, such stimulation either before or during PVI is even purported to suppress its advantages [8,9]. This power of clitoral stimulation to 'trump' the benefits of PVI stimulation seems remarkable especially as the latter is supposedly favoured by evolution as the only sexual behaviour promoting gene propagation. ...
... iii) Greater use of some immature psychological defense mechanisms (in Freudian theory used to ward off anxiety) [9]. iv) Relationship difficulties (insecure attachment style determined by early childhood experiences) [16]. ...
... iv) Relationship difficulties (insecure attachment style determined by early childhood experiences) [16]. v) Psychosexual immaturity [9]. ...
An extensive series of papers by Brody and co-workers using questionnaires have correlated penile vaginal intercourse (PVI) and clitoral stimulation with various female functions and malfunctions. A major claim is that only PVI 'competently performed and sensitively experienced' leading to orgasm is 'associated with. and in some cases, causes processes associated with better psychological and physical functioning'. Clitoral stimulation to orgasm per se or to facilitate orgasm even during PVI, however, is not beneficial to women's psychological, interpersonal or behavioural health and can lead to 'noxious consequences'. Recently , as correlations are no guarantee of causation, independent studies have not confirmed some of their claims. The present review examines critically and rejects :- the demonising of the clitoris as an organ inducing 'deadly pleasures' or that it should become vestigeal by self-creating a 'psychological clitoridectomy', that evolution 'rewards' PVI but punishes clitoral stimulation, that cervical buffeting is normally involved in PVI-orgasms or that a longer penis facilitates these, that orgasm is involved in sperm transport and thus reproductive fitness, that prolactin released at orgasm is an instigator of sexual satiation, that the coital alignment technique does not involve clitoral and periurethral glans stimulation by the penis and that women who cannot have orgasms induced by PVI alone are sexually dysfunctional and that their male partners are sexually inadequate.
... Email: lori.brotto@vch.ca health, partnership, mental health, and life satisfaction, lending further support for this assertion that PVI is an indicator of health (Brody & Costa, 2005, 2009Brody & Weiss, 2011;Costa & Brody, 2007;Weiss & Brody, 2009). The association between vaginal orgasm and better psychological health was also explored by comparing defence styles of anorgasmic non-clinical women to the defence styles of ''neurotic-level'' Portuguese outpatients. ...
... The association between vaginal orgasm and better psychological health was also explored by comparing defence styles of anorgasmic non-clinical women to the defence styles of ''neurotic-level'' Portuguese outpatients. Using the Defence Style Questionnaire, Brody and Costa (2005) found that women experiencing vaginal orgasm showed less somatization, dissociation, displacement, autistic fantasy, devaluation, and isolation of affect. The researchers concluded that anorgasmic and infrequently orgasmic with PVI women used immature psychological defence styles, such as depression, and they interpreted their findings as supporting their claim that women who prefer masturbation over intercourse were more likely to have symptoms of depression (Brody & Costa, 2005). ...
... Using the Defence Style Questionnaire, Brody and Costa (2005) found that women experiencing vaginal orgasm showed less somatization, dissociation, displacement, autistic fantasy, devaluation, and isolation of affect. The researchers concluded that anorgasmic and infrequently orgasmic with PVI women used immature psychological defence styles, such as depression, and they interpreted their findings as supporting their claim that women who prefer masturbation over intercourse were more likely to have symptoms of depression (Brody & Costa, 2005). On the other hand, PVI orgasm consistency was found not to be associated with demographic variables such as current relationship status, education level, or years of intercourse experience (Brody, 2006(Brody, , 2007a. ...
Article
A substantial body of research supports the hypothesis that vaginal orgasm is associated with overall better health outcomes for women. The primary aim of this study was to examine correlates of orgasm consistency with intercourse (OCI) in a sample of women with sexual dysfunction to see whether these findings held in a clinical sample. Study 1 (n = 255) focused on demographic and psychological correlates of OCI and Study 2 (n = 81) focused on the association between sexual arousal concordance and OCI. A longer relationship length and higher orgasm scores predicted OCI whereas mood, sexual abuse history, and relationship satisfaction did not. In Study 2, sexual arousal concordance, as measured with vaginal photoplethysmography and a continuous self-report measure of sexual arousal, was not associated with OCI. These findings challenge the conclusions of Brody et al. that vaginal orgasm is a sign of psychological, sexual, and relational health.
... Clitorally focused masturbation, vaginally focused masturbation, oral sex, and anal sex were differentiated as occurring with or without PVI in the same day [22,23,29,30]. This sexual behavior questionnaire and previous versions in other languages [31][32][33] have been used in studies demonstrating predicted differences between sexual activities. Recall and diary measures of sexual behavior frequencies in a previous version were strongly correlated [33]. ...
... These findings strengthen the view that penis size is more relevant for women who are more sexually responsive to penile stimulation of the vagina and cervix. Higher vaginocervical responsiveness among women who can more easily attain vaginal orgasm might be related, at least in part, to greater thickness and/or length of the urethrovaginal space [34,35], better vagus nerve function [30,33], more awareness of vaginal erotic responses [36,37], more attention to vaginal sensations during PVI [5], better pelvic region muscle function [38], better psychological functioning in at least some respects [4,20,22,29,32,39,40], better intimate relationship quality [4,20,31,40], and higher sexual desire [40,41]. ...
... In other studies, a higher proportion of Arabic and Croatian women reported Table 5 Univariate analyses of covariance comparing those women who are more likely to orgasm from PVI with a longer than average penis to those women who are not more likely to orgasm from PVI with a longer than average penis regarding frequency (days in a previous month) of sexual behaviors [2,14], but such studies did not ask about the specific importance of larger than average penises; an average penis size can be considered important by many women if compared with a shorter than average penis. Notably, the roughly 30% of women reporting that penis size is not important in these studies is similar to the estimated prevalence of 30% of women who have not had vaginal orgasms [32]-a prevalence that was again confirmed in this study. Our results might slightly underestimate women's true size preferences because our references for an "average" penis length (the £20 note at 149 mm long and the U.S. dollar bill at 155 mm long) are slightly longer than the approximately 148-mm mean erect penis length found when averaging results across several studies [27]. ...
Article
Full-text available
Introduction. Research indicates that (i) women's orgasm during penile–vaginal intercourse (PVI) is influenced by fitness-related male partner characteristics, (ii) penis size is important for many women, and (iii) preference for a longer penis is associated with greater vaginal orgasm consistency (triggered by PVI without concurrent clitoral masturbation). Aims. To test the hypothesis that vaginal orgasm frequency is associated with women's reporting that a longer than average penis is more likely to provoke their PVI orgasm. Method. Three hundred twenty-three women reported in an online survey their past month frequency of various sexual behaviors (including PVI, vaginal orgasm, and clitoral orgasm), the effects of a longer than average penis on likelihood of orgasm from PVI, and the importance they attributed to PVI and to noncoital sex. Main Outcome Measures. Univariate analyses of covariance with dependent variables being frequencies of various sexual behaviors and types of orgasm and with independent variable being women reporting vs. not reporting that a longer than average penis is important for their orgasm from PVI. Results. Likelihood of orgasm with a longer penis was related to greater vaginal orgasm frequency but unrelated to frequencies of other sexual behaviors, including clitoral orgasm. In binary logistic regression, likelihood of orgasm with a longer penis was related to greater importance attributed to PVI and lesser importance attributed to noncoital sex. Conclusions. Women who prefer deeper penile–vaginal stimulation are more likely to have vaginal orgasm, consistent with vaginal orgasm evolving as part of a female mate choice system favoring somewhat larger than average penises. Future research could extend the findings by overcoming limitations related to more precise measurement of penis length (to the pubis and pressed close to the pubic bone) and girth, and large representative samples. Future experimental research might assess to what extent different penis sizes influence women's satisfaction and likelihood of vaginal orgasm. Costa RM, Miller GF, and Brody B. Women who prefer longer penises are more likely to have vaginal orgasms (but not clitoral orgasms): Implications for an evolutionary theory of vaginal orgasm. J Sex Med 2012;9:3079–3088.
... Psychological defense mechanisms serve to reduce distress caused by emotional conflict. Maladaptive psychological defense mechanisms involve a distortion of reality and/or impairment of awareness, and they are associated with a variety of indices of poorer mental health and interpersonal relatedness, psychological immaturity, lesser ability to relate intimately with the opposite sex, lack of emotional awareness, and with a variety of psychiatric disorders [3,66]. Because of their association with some of the normal processes found in small children (as well as with more pathological mechanisms) and the inference that adverse events in childhood can impair the ability to progress to more adaptive and mature levels of emotional development and emotion regulation, maladaptive psychological defenses are also termed immature [3,66]. ...
... Maladaptive psychological defense mechanisms involve a distortion of reality and/or impairment of awareness, and they are associated with a variety of indices of poorer mental health and interpersonal relatedness, psychological immaturity, lesser ability to relate intimately with the opposite sex, lack of emotional awareness, and with a variety of psychiatric disorders [3,66]. Because of their association with some of the normal processes found in small children (as well as with more pathological mechanisms) and the inference that adverse events in childhood can impair the ability to progress to more adaptive and mature levels of emotional development and emotion regulation, maladaptive psychological defenses are also termed immature [3,66]. Originally a psychodynamic construct, the concept of psychological defenses and their level of adaptiveness or maturity, has become much less bound to a specific theoretical orientation. ...
... As is common with the sometimes arbitrary changes of fashion found in subsequent editions of DSM, psychological defenses are mentioned far less in DSM-5 (in which immature defense mechanisms as such are mentioned in the context of dissociative disorders) [15]. In a Portuguese sample [66], vaginal orgasm was associated with less overall use of immature psychological defense mechanisms and with less use of the specific component immature defenses of dissociation, somatization, displacement, autistic fantasy, devaluation, and isolation of affect. Orgasm triggered by clitoral stimulation or by clitoral masturbation (by either partner) concurrent with penile-vaginal intercourse stimulation was not associated with less use of immature defense mechanisms and was actually associated with more use of some immature defense mechanisms. ...
Chapter
The issues to be considered and approaches to be used in the evaluation of female orgasmic disorder are presented in the context of research evidence and best clinical practice. The sections in this chapter include epidemiology, etiology, pathophysiology, DSM-5 and ICD-10 diagnostic criteria, and approach to diagnosis (including diagnostic scales and issues to be considered during the clinical interview). Psychological, behavioral, interpersonal, pharmacological, and physiological factors related to female orgasmic disorder are reviewed. The psychological and behavioral issues include family and other developmental and experiential factors, exercise, personality traits, attachment, psychopathology, intimate relationship function, specifics of sexual behaviors, mental focus during sexual activity, specifics of sex education, and partner characteristics including partner sexual function. The physiological factors reviewed include prenatal factors, age, nutrition and substance use, medical conditions and treatments, hormonal influences, autonomic tone, muscle tone, and both peripheral and central neurophysiological pathways. The problem of fluctuating diagnostic criteria is addressed, and the issue of whether a distress criterion scientifically or clinically merits being a requirement for the diagnosis of female orgasmic disorder is evaluated. The evidence for differences between orgasm triggers (including the special psychological, physiological, and interpersonal aspects of vaginal orgasm) is presented. The implications of the process of evaluation of female orgasmic disorder for its treatment formulation are also presented.
... It has been exaggeratedly claimed that sexual arousal to orgasm by penile vaginal intercourse (PVI) alone without any other sexual stimulation, especially clitoral, has a 'myriad demonstrated benefits' to women in terms of their psychological, physiological, and physical health compared to that induced by clitoral stimulation per se (Brody, 2010; Hess 2012)-but see Table 1 for the actual benefits listed against the known harmful conditions that can arise even from consensual PVI. Even promoting clitoral stimulation is said to create the possibility of 'iatrogenic damage' (Brody and Costa, 2008) but such evidence that this has occurred has never been presented. Furthermore, it is also stated that if PVI is accompanied by clitoral stimulation it detracts from impairs or diminishes the purported beneficial features of PVI (Brody and Costa, 2008;Brody, 2010;Costa, 2012). ...
... Even promoting clitoral stimulation is said to create the possibility of 'iatrogenic damage' (Brody and Costa, 2008) but such evidence that this has occurred has never been presented. Furthermore, it is also stated that if PVI is accompanied by clitoral stimulation it detracts from impairs or diminishes the purported beneficial features of PVI (Brody and Costa, 2008;Brody, 2010;Costa, 2012). It seems remarkable that Brody et al. consider PVI as the only sexual behavior that can bring about pregnancy and gene reproduction and thus is 'rewarded' by evolution as its so-called benefits can so easily be detracted, impaired, diminished by the added arousal from clitoral stimulation and the 'untoward effect of other sexual activities' (Brody, 2010). ...
... While Brody and Costa (2008) stated that 'clitoral orgasm is at best an intermediate state between global anorgasmia and being fully vaginally orgasmic', many published studies discount the claim. Two set of investigators investigating masturbation commented on its role in adults. ...
Article
This article reviews clitoral structures, their functions and how they are activated during the stages of female life. The paradox that occurs is that different procedures of activation are claimed by some to favour ‘noxious outcomes' to the physical and psychic health of women who use it to achieve sexual arousal/orgasm with or without penile vaginal intercourse. A number of the difficulties and inconsistencies in relation to these claims are explored. The proposed justification for the ‘noxious outcomes' is that ‘evolution' punishes sexual arousals other than by coitus because it is the only one that leads to gene propagation. In this context, however, the new, evolutionary interpretation of clitoral function in the fertile years as a fundamental proximate mechanism for facilitating female reproductive fitness makes such a justification improbable. The role of coital alignment technique (CAT) in the treatment of female orgasmic disorder is discussed in relation to its features of introital, clitoral and periurethral glans stimulation. Attempts to control female sexuality through various ‘clitoridectomies' are examined and unanswered questions about clitoral stimulation are listed. This article is protected by copyright. All rights reserved.
... Similarly, the loss of vaginal fluid was believed to cause a variety of mental disorders including hysteria and epilepsy (Levin, 2007). While there has been no evidence to support these claims, masturbation has been found to correlate with other psychological discomforts including decreased life satisfaction (Brody & Costa, 2009), use of immature psychological defense mechanisms (Brody & Costa, 2008), and depression (Gallup, Burch, & Platek, 2002). ...
... Of greater relevance, a study conducted in Portugal aimed to investigate the link between psychological immaturity and inability to achieve vaginal orgasm (Brody & Costa, 2008). This study aimed to investigate the psychoanalytic idea that, as women mature, clitoral sensitivity should, at least in part, be transferred to the vagina (Freud, 1953, P. 118). ...
... Female subjects were instructed to fill out The Defense Style Questionnaire (DSQ-40) along with a questionnaire to determine how frequently they engaged in various sexual activities. Orgasm from masturbation was found to be correlated with immature psychological defense mechanism use (Brody & Costa, 2008). A follow up study asked subjects to fill out the DSQ-40, a questionnaire regarding frequency of engagement in various sexual activities and a questionnaire regarding frequency of alcohol consumption before sex. ...
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Examining Correlations Between Reasons for Masturbation and Depressive Symptoms /Immature Psychological Defense Mechanism Use. I am an undergraduate working on a research project. The current document is a research proposal. Feel free to message me. Any advice is appreciated.
... Clitorally focused masturbation, vaginally focused masturbation, oral sex, and anal sex were differentiated as occurring with or without PVI in the same day [22,23,29,30]. This sexual behavior questionnaire and previous versions in other languages [31][32][33] have been used in studies demonstrating predicted differences between sexual activities. Recall and diary measures of sexual behavior frequencies in a previous version were strongly correlated [33]. ...
... These findings strengthen the view that penis size is more relevant for women who are more sexually responsive to penile stimulation of the vagina and cervix. Higher vaginocervical responsiveness among women who can more easily attain vaginal orgasm might be related, at least in part, to greater thickness and/or length of the urethrovaginal space [34,35], better vagus nerve function [30,33], more awareness of vaginal erotic responses [36,37], more attention to vaginal sensations during PVI [5], better pelvic region muscle function [38], better psychological functioning in at least some respects [4,20,22,29,32,39,40], better intimate relationship quality [4,20,31,40], and higher sexual desire [40,41]. ...
... In other studies, a higher proportion of Arabic and Croatian women reported Table 5 Univariate analyses of covariance comparing those women who are more likely to orgasm from PVI with a longer than average penis to those women who are not more likely to orgasm from PVI with a longer than average penis regarding frequency (days in a previous month) of sexual behaviors [2,14], but such studies did not ask about the specific importance of larger than average penises; an average penis size can be considered important by many women if compared with a shorter than average penis. Notably, the roughly 30% of women reporting that penis size is not important in these studies is similar to the estimated prevalence of 30% of women who have not had vaginal orgasms [32]-a prevalence that was again confirmed in this study. Our results might slightly underestimate women's true size preferences because our references for an "average" penis length (the £20 note at 149 mm long and the U.S. dollar bill at 155 mm long) are slightly longer than the approximately 148-mm mean erect penis length found when averaging results across several studies [27]. ...
... For women with PVI normally lasting at least 16 minutes, two thirds attained coital orgasm on 90–100% of the PVI occasions (Gebhard, 1966). Even assuming that 30% of women never had vaginal orgasm (Brody & Costa, 2008), that is not an argument against the view that vaginal orgasm is an adaptation. Other dysfunctional conditions have high prevalence, such as being overweight or substance abuse, but high prevalence does not transform an unhealthy condition into a healthy one. ...
... In fact, there is evidence that condom use is more common among persons involved in relationships with decreased intimacy and feeling less love for their partners (Aalsma, Fortenberry, Sayegh, & Orr, 2006; Civic, 1999). Moreover, condom use or reduced frequency of PVI without condoms have been associated with more use of immature defense mechanisms (Costa & Brody, 2008), depression (Gallup, Burch, & Platek, 2002; Morrill, Ickovics, Golubchikov, Beren, & Rodin, 1996; Smit et al., 2006), poorer immune function (Peters et al., 2004) and higher body mass index (Akers et al., 2009). A series of studies have shown a relationship of history of condom use or coitus interruptus with greater risk of breast cancer (Gjorgov, 1978, 1998; Le et al., 1989; Vessey et al., 1983). ...
Article
The authors reply to a quartet of recent articles in this journal. We detail certain misrepresentations and the dismissal of existing research in those articles (including attempts at denial of the repeatedly documented association of lack of vaginal orgasm with greater use of immature psychological defense mechanisms and other indices of poorer health). The authors also call for a less defensive and less doctrinaire approach to sex research, especially, but not exclusively, when the prevailing ideology in the fields of sexology might be undermining optimal health.
... Unlike unhealthy food and television viewing, penile-vaginal intercourse (PVI) is a clearly evolutionarily relevant behavior involving significant effort and the experience of powerful emotions. In contrast to television viewing and junk food, PVI frequency and/or PVI orgasmic ability are associated with several indices of better physical and mental health (Brody, 2010;Costa and Brody, 2012), including indices of better emotional regulation and nutrition-related benefits, such as nutritional enhancement effects of ascorbic acid (Brody, 2002), less alexithymia (Brody, 2003), lesser alcohol consumption before sex (Costa and Brody, 2010), slimness (Brody, 2004;Brody and Weiss, 2012 ), greater resting heart rate variability , and less use of immature defense mechanisms (Brody and Costa, 2008;Brody et al., 2010;Brody, 2010, 2011). In contrast, frequency of noncoital sex (partnered or solitary) and likelihood of orgasm therefrom are generally uncorrelated with these health indices (Brody, 2010), or sometimes even correlated with more use of immature defense mechanisms (Brody and Costa, 2008;Brody, 2010, 2011). ...
... In contrast to television viewing and junk food, PVI frequency and/or PVI orgasmic ability are associated with several indices of better physical and mental health (Brody, 2010;Costa and Brody, 2012), including indices of better emotional regulation and nutrition-related benefits, such as nutritional enhancement effects of ascorbic acid (Brody, 2002), less alexithymia (Brody, 2003), lesser alcohol consumption before sex (Costa and Brody, 2010), slimness (Brody, 2004;Brody and Weiss, 2012 ), greater resting heart rate variability , and less use of immature defense mechanisms (Brody and Costa, 2008;Brody et al., 2010;Brody, 2010, 2011). In contrast, frequency of noncoital sex (partnered or solitary) and likelihood of orgasm therefrom are generally uncorrelated with these health indices (Brody, 2010), or sometimes even correlated with more use of immature defense mechanisms (Brody and Costa, 2008;Brody, 2010, 2011). This pattern has been interpreted as better emotional regulation (among other aspects of health) favoring performance specifically during PVI and/or being supported by engaging in and responding fully to PVI (Brody, 2010;Brody, 2010, 2012). ...
Article
Immature psychological defense mechanisms are psychological processes that play an important role in suppressing emotional awareness and contribute to psychopathology. In addition, unhealthy food, television viewing, and alcohol consumption can be among the means to escape self-awareness. In contrast, engaging in, and responding fully to specifically penile-vaginal intercourse (PVI) is associated with indices of better emotional regulation, including less use of immature defense mechanisms. There was a lack of research on the association of immature defense mechanisms with personal importance of junk food, alcohol, television, PVI, and noncoital sex. In an online survey, 334 primarily Scottish women completed the Defense Style Questionnaire (DSQ-40), and rated the personal importance of junk food, alcohol, television, PVI, and noncoital sex. Immature defense mechanisms correlated with importance of junk food, alcohol, and television. Importance of PVI correlated with mature defenses, and less use of some component immature defenses. Importance of alcohol correlated with importance of junk food, television, and noncoital sex. Importance of junk food was correlated with importance of television and noncoital sex. The findings are discussed in terms of persons with poorer self-regulatory abilities having more interest in junk food, television, and alcohol, and less interest in PVI.
... Psychological inhibitions can decrease attention to sexual stimuli and awareness of sexual motivation (Bloemers et al., 2013;Brody & Costa, 2008Costa & Brody, 2010Costa & Oliveira, 2015;Poels et al., 2013;van der Made et al., 2009;van Rooij et al., 2013). Thus, future research might explore to what extent psychological inhibitions and maladaptive ways of coping with psychological conflicts interfere with absorbed states during sex. ...
... Greater frequency of and orgasmic responsiveness from vaginal intercourse without clitoral masturbation is associated with several indices of better health and well-being (Brody, 2010;Brody & Costa, 2008;Costa & Brody, 2010, 2012a 2012b). Future research might examine to what extent the intensity of absorption during sex causes or otherwise explains these relationships. ...
... For example, based on psychoanalytic theory relating women's orgasms to psychological maturity, Brody and Costa (2008) found that several DSQ-40 immature defense-mechanism scores, as well as the aggregated immature defense-style score, were negatively related to experiencing orgasms during penile-vaginal intercourse. Watson (2002) found that scores on the DSQ-40 displacement items comprised the primary predictor of several psychiatric symptoms among women, whereas men's symptoms were predominately predicted by their scores on projection, suggesting that specific immature defenses as assessed by the DSQ-40 are differentially related to symptomatology scores across gender. ...
... It would be incorrect to assume that the present findings regarding the dimensionality of the individual defense-mechanism scales (i.e., parcels) of the DSQ-40 is only of statistical interest. The DSQ-40 defense-mechanism scales have been used as predictor variables in a number of studies exploring a variety of topics (e.g., Brody & Costa, 2008;Watson, 2002). For example, based on their findings with the DSQ-40, Bovey and Hede (2001) argued that employees in organizations undergoing restructuring were likely to resist such change due to their use of projection in an attempt to externalize the source of their personal anxiety. ...
Article
The Defense Style Questionnaire-40 (DSQ-40; Andrews, Singh, & Bond, 1993) uses pairs of items to measure 20 individual defense mechanisms. In a statistical sense, these item pairs represent parcels and are subject to the standards of unidimensionality demanded of parcels in general. Using a 2-facet modeling approach (N = 672), the present study examined the dimensionality of the defense-mechanism parcels in the DSQ-40 and found that the majority of the parcels did not satisfy the criteria for unidimensionality. In addition, the original 3-factor model of defense styles was not tenable with the present data. Overall, the results suggest caution when attempting to assess individual defense mechanisms using the DSQ-40. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
... Women who are not able to obtain vaginal orgasm and have difficulty with orgasm are sometimes seen as being emotionally unstable, not open to new experiences, introverted (Harris et al., 2008). For others, absence of vaginal orgasm, as back in Freud's days, appeared highly correlated with immature defence mechanisms (Brody and Costa, 2008). A very recent British study of 2035 women attempted to establish a correlation between a very low emotional intelligence score and the inability to reach orgasm (Burri et al., 2009). ...
Article
Full-text available
In this article, we propose a review of data from scientific, anatomic, physiological and clinical literature, combined with sociological and historic data, with a view to providing a holistic picture of our knowledge of the subject. We will particularly focus on the growth of our scientific knowledge and how it is structured, in parallel to the changes that have taken place in cultural and historic factors related to our representations of the female orgasm. Controversies on the subject of female sexuality and the nature of the female orgasm are still present today, after mobilising feminists for more than half a century. You can almost follow the recent history of women in the progression of heated debate that has taken place over nearly two centuries about the nature of the female climax; vaginal or clitoridian. After the domination of vaginal orgasm at the end of the 19th century and early into the 20th, the supremacy of the clitoris became the cornerstone of feminist struggles; the symbol of social and sexual emancipation for women in the second half of the 20th century. There are still many areas of the female orgasm that are unclear today, in particular the existence of the G-Spot and female ejaculation, which since the 1980s have been a topic of much fervent debate in the media, rendering an objective scientific assessment of the relevant facts very difficult. More recent studies, using modern means of investigation have revealed, in opposition to the classic dichotomy between vaginal and clitoridian orgasm, the concept of clitoral complex and integrated and functional entity at the origin of female pleasure linking the clitoris, the vulva, the vagina, the uterus and the anus, opening up new prospects for understanding the female orgasm.
... [25] Condom have a detrimental effect on women's orgasm and frequency of sex with condom is directly correlated with abnormal defense mechanisms they use such as suicide and depression. [26] Women who do not use condom are happier and depression and suicide are less in them than those who tend to have active sex with condom. [27] Some researchers speculated that probable mechanisms are involved in creating psychological effect of sexual activity one of which can be chemical substances exchange such as sexual pheromones. ...
Article
Full-text available
None of the contraceptive methods are fully side-effect free. One of the side effects that commonly causes discontinuation is mood changes and depression. The present study aimed to compare the depression between contraceptive methods including low-dose estrogen (LD) combined pills, condom and intrauterine devices (IUD). In a cross-sectional study, 216 women were selected through systematic random sampling from 10 health care center sin Isfahan in 2011. Beck Depression Inventory II was used and individual productivity characteristics were asked. Validity and reliability of Beck depression inventory have been repeatedly confirmed in Iran. Content validity the productivity characteristics questionnaire was confirmed and its reliability was measured through Cronbach's alpha correlation coefficient (calculated as 0.71). ANOVA, covariance analysis and logistic regression were used to analyze the data. Depression was observed in 47.8% of participants; however, there was no difference between mean score of depression in the users of three contraceptive methods. The findings of this study showed that depression is not correlated with family planning type and fear of depression should not be an obstacle to choose between these methods. Depression is a multifactor issue. This study showed that type of family planning method in itself cannot be the cause of depression and family planners and consultants should consider this.
... Women who are not able to obtain vaginal orgasm and have difficulty with orgasm are sometimes seen as being emotionally unstable, not open to new experiences, introverted (Harris et al., 2008). For others, absence of vaginal orgasm, as back in Freud's days, appeared highly correlated with immature defence mechanisms (Brody and Costa, 2008). A very recent British study of 2035 women attempted to establish a correlation between a very low emotional intelligence score and the inability to reach orgasm (Burri et al., 2009). ...
Article
Brusquement passée des ténèbres du continent noir où l’avait cantonné un siècle de psychanalyse, à l’aveuglante clarté de la médecine basée sur les preuves, la sexualité féminine n’en a pas pour autant livré tous ses secrets. L’orgasme des femmes, qui n’en finit pas de susciter débats et controverses depuis le xixe siècle en est une excellente illustration. Nombre de zones d’ombre persistent encore de nos jours, en particulier au niveau de l’existence du point G., qui a fait l’objet depuis les années 1980, d’un important phénomène médiatique rendant très difficile une lecture scientifique des faits s’y attachant. Il est quasiment possible de lire l’histoire récente des femmes au travers des grands débats d’idées qui nous agitent depuis près de deux siècles sur la nature de leur jouissance, vaginale ou clitoridienne. Au primat de l’orgasme vaginal de la fin du xixe siècle et du début du suivant, a succédé la dictature du clitoris des combats féministes, marquant l’émancipation sociale et sexuelle des femmes de la seconde moitié du xxe siècle. Mais les études les plus récentes, utilisant des moyens d’investigations modernes, font apparaître, derrière la classique opposition entre orgasme vaginal contre clitoridien, le concept d’une véritable unité anatomofonctionnelle liant clitoris, vulve, vagin, urètre et anus, sous la dépendance d’un même axe neurophysiologique. Le débat sur la sexualité féminine et la nature de l’orgasme au féminin est cependant toujours ouvert, après avoir mobilisé un demi-siècle de féminisme, et même si l’heure n’est plus à la guerre des sexes, il est encore très difficile de faire la part des choses entre évidences scientifiques et fausses croyances sur la sexualité féminine alimentant de trop nombreuses idées reçues.
... Com relação à associação entre os estilos defensivos e o funcionamento sexual, encontra-se na literatura estudos que abordam comportamentos sexuais e não às etapas do funcionamento em si. Nessas investigações, as defesas imaturas estão relacionadas a um maior consumo de álcool antes de relações sexuais (Costa & Brody, 2010), menor obtenção de orgasmos vaginais em mulheres (Brody, Houde, & Hess, 2010;Brody & Costa, 2005;Costa & Brody, 2010) e maior vontade e frequência em ter comportamentos masturbatórios (Brody & Nicholson, 2013). ...
Article
Full-text available
RESUMO: Esse estudo teve como principal objetivo avaliar a relação entre os estilos defensivos e o funcionamento sexual. O delineamento do estudo foi descritivo, transversal, correlacional e contou com 1170 participantes, de nacionalidades portuguesa e brasileira, dentre os quais 359 (30,7%) são homens e 801 (68,5%) são mulheres com idades entre 18 e 81 anos (M = 28,9; DP = 11,9). Os resultados apontaram correlações positivas entre os níveis de defesa maduro e o funcionamento sexual, satisfação com a vida, felicidade geral e saúde. O estilo imaturo esteve correlacionado negativamente com essas mesmas variáveis, enquanto o funcionamento sexual manteve correlação positiva. Os resultados foram corroborados pela literatura, que aponta a relação entre o uso de defesas maduras e um melhor funcionamento sexual e em outras áreas da vida. Por fim, salientou-se a necessidade de mais investigações que abordem os estilos defensivos e o funcionamento sexual. Palavras-Chave: estilos defensivos, mecanismos de defesa, funcionamento sexual. DEFENSIVE STYLES AND SEXUAL FUNCTIONING IN ADULTS ABSTRACT: The main objective of this study is to evaluate the interface between defensive styles and sexual functioning. The study design was descriptive, transversal, correlational and counted with 1170 participants, of Portuguese and Brazilian nationalities, among whom 359 are men (30.7%) and 801 (68.5%) are women aged between 18 and 81 years (M = 28.9, SD = 11.9). The instruments used were a sociodemographic questionnaire, Defense Style Questionnaire (DSQ-40) and Massachusetts General Hospital-Sexual Function Questionnaire (MGH-SFQ). The results point to positive correlations between levels of defense and sexual performance, satisfaction with life, general happiness and health. The style was negatively correlated with these variables, while the sexual control was maintained positive. The results were corroborated by the literature, which points out a relationship between the use of mature defenses and a better sexual functioning and in other areas of life. Finally, the need to investigate the relationship between defensive styles and sexual functioning was better explained. In addition to the article, this project has a theoretical annex where all the constructs addressed are elaborated in order to deepen and consolidate the theoretical foundations of the presente empirical article.
... Psychodynamically informed studies might also attempt to examine the possibility that some men with PE are expressing anger passive-aggressively toward women by depriving them of the opportunity to enjoy intercourse. A limitation of the present study is that only a simple query was made regarding perceived relationship with mother, so future studies would benefit from using more sophisticated measures, such as level of psychological defense mechanisms (found to be associated with impairments of female sexual function in multiple studies [28][29][30][31][32][33]). Some of the significant observed effect sizes (such as the association of IPE with poorer perceived mother relationship) are small. ...
Article
IntroductionBoth erectile dysfunction (ED) and premature ejaculation (PE) impair the quality of sexual intercourse for both men and their female partners.AimsThis study aims to examine with a large representative sample the interrelationships of measures of ED, PE, typical intravaginal ejaculatory latency time (IELT), men's perceived relationship quality with their mother, and age of first being in love.Methods In this cross-sectional study, a nationally representative sample of 960 Czech coitally experienced men (aged 15-84), provided age, International Index of Erectile Function 5-item (IIEF-5), Index of Premature Ejaculation (IPE) scores, IELT, rating of relationship with their mother, and age at first being in love.Main Outcome MeasuresCorrelations, partial correlations adjusting for age, analysis of covariance (ANCOVA), and multiple regression statistical methods were used.ResultsIIEF-5, IPE, and IELT were significantly intercorrelated (IIEF-5 and IPE: r = 0.64). Better IIEF-5 scores were associated with younger age at first (and ever) being in love. Poorer IPE score, shorter IELT, and mild-moderate ED were associated with poorer perceived mother relationship (which was also associated with first being in love at an older age). Multiple regression analyses revealed that: (i) greater IELT was associated with better erectile function and better mother relationship, but not with age; and (ii) IELT of <1 minute was associated with poorer perceived mother relationship and poorer IIEF-5, but marginally with age. History of homosexual activity was unrelated to IIEF-5, IPE, IELT, and perceived mother relationship scores.Conclusions The findings suggest that degrees of ED and PE are often comorbid, and both ED and PE are associated with less favorable early experiences with women. Brody S and Weiss P. Erectile dysfunction and premature ejaculation: Interrelationships and psychosexual factors. J Sex Med 2015;12:398-404.
... Since Kinsey, many sexologists have asserted that no such link exists [20]. However, little evidence-based research has been done to try to confirm these hypotheses [21,22]. ...
Article
Introduction: Women describe at least two types of orgasms: clitoral and vaginal. However, the differences, if any, are a matter of controversy. In order to clarify the functional anatomy of this sexual pleasure, most frequently achieved through clitoral stimulation, we used sonography with the aim of visualizing the movements of the clitorourethrovaginal (CUV) complex both during external, direct stimulation of the clitoris and during vaginal stimulation. Method: The ultrasounds were performed in three healthy volunteers with the General Electric® Voluson® sonography system (General Electric Healthcare, Vélizy, France), using a 12-MHz flat probe and a vaginal probe. We used functional sonography of the stimulated clitoris either during manual self-stimulation of the external clitoris or during vaginal penetration with a wet tampon. Main outcome measures: Functional and anatomic description, based on bidimensional ultrasounds, of the clitoris and CUV complex, as well as color Doppler signal indicating speed of venous blood flow, during arousal obtained by external or internal stimulation. Results: The sagittal scans obtained during external stimulation and vaginal penetration demonstrated that the root of the clitoris is not involved with external clitoral stimulation. In contrast, during vaginal stimulation, because of the movements and displacements, the whole CUV complex and the clitoral roots in particular are involved, showing functional differences depending on the type of stimulation. The color signal indicating flow speed in the veins mirrored the anatomical changes. Conclusions: Despite a common assumption that there is only one type of female orgasm, we may infer, on the basis of our findings, that the different reported perceptions from these two types of stimulation can be explained by the different parts of the clitoris (external and internal) and CUV complex that are involved.
... ''. . . how many days in the past month each of the following behaviors occurred: penile-vaginal intercourse, penile-vaginal intercourse orgasm (using no extrinsic clitoral stimulation), penile-vaginal intercourse orgasm involving simultaneous self or partner clitoral stimulation for orgasm, masturbation (activity and orgasm) and noncoital partnered sex (sexual interaction with a partner with the exception of penile-vaginal intercourse; activity and orgasm)''(Brody & Costa, 2008, p. 1168), ''. . . women who had at least one orgasm from the activity that month are compared with regard to immature defenses with women who had no orgasm from that activity . . . ...
Article
Full-text available
A string of publications by Brody and colleagues purport to identify health implications in women who report reaching orgasm from vaginal/partnered versus clitoral/solo stimulation. Brody, Costa and Hess (2012) responded to a number of critiques of this line of research, including one by this author (Prause, 2011). Brody, Costa and Hess (2012) elected not to address two of the most critical problems raised: (1) a lack of any theoretical foundation and (2) the absence of psychometric support for their primary measurement. Rebuts are provided for the issues addressed. Also, new data are presented: (1) demonstrating the inadequacy of their methods, (2) falsifying of the vaginal-is-always-optimal prediction, (3) failing to replicate previous reports by Brody and colleagues and (4) documenting confounds of Brody and colleagues measures. Approaches for researchers interested in testing a vaginal-is-always-optimal prediction are suggested in an effort to raise the standards of the science in this area of study.
... Sex in this company is no different, but what makes sex apparently distinct is that the neural path(s) that have been used or created during youthful clitoral masturbation, often the first initiator of female sexual pleasure, have to be either bypassed or superseded by conscious effort using vaginal stimulation, but only by PVI, with no other sexual stimulation (Levin, 2014b). This suggests that the original "clitoral" pathway(s) must be exceptionally strong and functionally dominant because, according to Brody and Costa (2008) and Brody (2010), if clitoral stimulation occurs during PVI, and even sometime before, the claimed benefits of PVI do not occur; clitoral stimulation simply trumps PVI. This is more than surprising considering that PVI is claimed by them to be the only sexual activity that can lead to gene propagation, and thus, should be more highly rewarded (Brody, 2010). ...
Article
This review deals critically with many aspects of the functional genital anatomy of the human female in relation to inducing sexual arousal and its relevance to procreation and recreation. Various controversial problems are discussed including: the roles of clitorally versus coitally induced arousal and orgasm in relation to the health of women, the various sites of induction of orgasm and the difficulty women find in specifically identifying them because of “'ambiguity problems” and “genital site pareidolia,” the cervix and sexual arousal, why there are so many sites for arousal, why multiple orgasms occur, genital reflexes and coitus, the sites of arousal and their representation in the brain, and identifying aspects and functions of the genitalia with appropriate new nomenclature. Clin. Anat., 2014. © 2014 Wiley Periodicals, Inc.
... [25] Condom have a detrimental effect on women's orgasm and frequency of sex with condom is directly correlated with abnormal defense mechanisms they use such as suicide and depression. [26] Women who do not use condom are happier and depression and suicide are less in them than those who tend to have active sex with condom. [27] Some researchers speculated that probable mechanisms are involved in creating psychological effect of sexual activity one of which can be chemical substances exchange such as sexual pheromones. ...
Article
Full-text available
Background: None of the contraceptive methods are fully side-effect free. One of the side effects that commonly causes discontinuation is mood changes and depression. The present study aimed to compare the depression between contraceptive methods including low-dose estrogen (LD) combined pills, condom and intrauterine devices (IUD). Materials and Methods: In a cross-sectional study, 216 women were selected through systematic random sampling from 10 health care center sin Isfahan in 2011. Beck Depression Inventory II was used and individual productivity characteristics were asked. Validity and reliability of Beck depression inventory have been repeatedly confirmed in Iran. Content validity the productivity characteristics questionnaire was confirmed and its reliability was measured through Cronbach's alpha correlation coefficient (calculated as 0.71). ANOVA, covariance analysis and logistic regression were used to analyze the data. Findings: Depression was observed in 47.8% of participants; however, there was no difference between mean score of depression in the users of three contraceptive methods. Conclusions: The findings of this study showed that depression is not correlated with family planning type and fear of depression should not be an obstacle to choose between these methods. Depression is a multifactor issue. This study showed that type of family planning method in itself cannot be the cause of depression and family planners and consultants should consider this.
... These immature mechanisms are associated with poorer mental health and various psychological disorders (Brody 2010; Bowins 2004;). The results of this study demonstrate that in contrast to those who engage in PVI, women who masturbate or are masturbated during intercourse make greater use of immature psychological defense mechanisms, including passive aggression, denial, and autistic fantasy (Brody and Costa 2008). Following the results of the Portuguese study, the authors attempted to conduct the same study on a larger Scottish sample. ...
Article
Masturbation is the stimulation of sexual organs usually to the point of orgasm with an essential autoerotic component. Due to the high prevalence of this sexual behavior, it was and still is a matter of debate if masturbation is a normal action without any side effects and even if it is advantageous or it is associated with side effects necessitating public education how to avoid it. In addition, it is a common question if masturbation is religiously lawful or not. In this study, I assess the results of scientific studies about this sexual behavior and also shed some light on the Islam’s view about it.
... He suggested that rather than being pure types, vaginal and clitoral orgasms could most parsimoniously be conceptualized simply as a single "genital orgasm." Although some evidence suggests psychological differences between women who report having "vaginal" versus "clitoral" orgasms (e.g., Brody 2007;Brody and Costa 2008), the responses of women who were asked to describe where their orgasms originated indicate that women may be unable to reliably differentiate clitorally-and vaginallyinduced orgasms (Clifford 1978;Prause 2011). Given the lack of controlled physiological studies investigating possible differences in the two putative types, there is insufficient evidence to conclude that stimulation of particular areas of women's genitals results in distinct types of orgasm. ...
Chapter
Full-text available
The difficulty of inducing orgasm in women, its variability between women, and the lack of an obvious relationship with women’s reproductive success have led some researchers to conclude that female orgasm is a nonfunctional by-product of developmental pathways that women share with men. Other researchers have presented evidence that orgasm is an adaptation in women. In this chapter, we review the evidence for these opposing points of view and find that a functional hypothesis receives greater support. First, we discuss the phenomenological, anatomical, and neurological correlates of women’s orgasm, which are generally inconsistent with the idea that female orgasm is a by-product. We then present evidence that female orgasm enhances the likelihood of conception, and we summarize evidence that female orgasm functions as a mechanism for choosing mates of high genetic quality, investment potential, or both. Finally, we outline directions for future research that will help to resolve the debate about the functionality of orgasm in women.
... In multiple studies conducted in various countries, greater orgasm consistency during PVI (in some cases, specifically vaginal orgasm was specified) was found to be associated with greater satisfaction with own sex life, own mental health, relationships with both partners and friends, and life in general (Brody, 2007a,b;Brody & Weiss, 2011), better emotion regulation (as indexed by less use of immature psychological defence mechanisms that are characterologically associated with various psychopathologies) (Brody & Costa, 2005;Brody, Houde, & Hess, 2010;Costa & Brody, 2010), greater peripheral tactile sensitivity , better intimate relationship satisfaction (Costa & Brody, 2007), better dyadic adjustment and sexual compatibility (Klapilová, Brody., Krejčová, Husárová, & Binter, 2015), more likelihood of an unimpaired (by functional pelvic muscular impairment) spontaneous gait (Nicholas, Brody, de Sutter, & de Carufel, 2008), less likelihood of insecure (anxious) attachment (Costa & Brody, 2011) better (greater) resting heart variability (an index of parasympathetic tone associated with a broad range of better physical and mental health including longevity) (Costa & Brody, 2012), less likelihood of having accumulated excess abdominal body fat (Costa & Brody, 2014), and less likelihood of female sexual arousal disorder (Weiss & Brody, 2009). Therrien and Brotto (2016) claim that findings by Brody and colleagues regarding the indices of healthier psychological and psychophysiological function in women who are more likely to reach orgasm during penile-vaginal intercourse (PVI) have not been reported by independent groups of researchers. ...
Article
A recent study by Therrien and Brotto (2016) examined the associations of orgasm during intercourse, concordance of laboratory genital and subjective arousal, and demographic variables in a group of sexually dysfunctional women. The authors claimed that their results cast doubt on the large body of multi-method multi-national research demonstrating that women's orgasm from penile-vaginal intercourse, and specifically vaginal orgasm are associated with a broad range of indices of women's better psychological, intimate relationship, and psychophysiological health. The problems with Therrien and Brotto's (2016) conclusions are discussed, and include that they did not even measure vaginal orgasm (they measured orgasm during intercourse, which can in some cases consist of orgasm elicited by clitoral masturbation during intercourse), and the non-generalisability of their findings from a sexually dysfunctional sample to the general population of women. Evidence is also presented against their claims that findings regarding orgasm during intercourse have not been investigated by other researchers, and their denial of differences between vaginal orgasm and clitoral orgasm. Denial of the myriad benefits of vaginal orgasm undermines women's sexual and general health potential, and serves only the demands of political correctness.
... Quoting only the controversial claims of Brody [72], and Brody and Costa [73], that there were psychological and other differences between women who report having 'vaginal' versus 'clitoral' orgasms without balancing them against the many specific criticisms of these studies by Levin [34][35][36]60], Prause [74,75], Laan and Rellini [76], which are now further supported by Prause, Kuang , Lee & Miller [77],Therrien and Brotto [78], and Brotto [79]. ...
Article
Abstract The present review examines the continued claims in a number of published articles that the oxytocin released by the human female orgasm is a component to enhance reproductive fitness by facilitating the rate or the amount, or both, of sperm transported to the ovum. The errors in these accounts, both of omission and commission, which undermine the claimed support for this proposed function of oxytocin are highlighted and discussed. Other functions of oxytocin present better candidates for its possible orgasmic actions.
... Female orgasm is a neuromuscular phenomenon triggered by sexual (somatic and mental) stimuli, accompanied by anatomical and physiological responses including vasocongestion of the erectile tissues, lubrication, and pelvic contractions that induce intense pleasurable sensations [1][2][3][4][5]. This female orgasm is not yet fully understood and defined, because of the great variability in factors including localization [6][7][8], stimulation techniques [9,10], self-image [11][12][13] and quality of romantic relationship [10,14]. It is therefore very difficult to describe female orgasm simply and concisely. ...
Article
Full-text available
The female orgasm represents one of the most complex functions in the field of human sexuality. The conjunction of the anatomical, physiological, psycho-relational and socio-cultural components contributes to make the female orgasm still partly unclear. The female orgasmic experience, its correlates and the relation with sexual desire, arousal and lubrication as predictors are highly debated in scientific community. In this context, little is known about the impact of female sexual dysfunction (SD) on sexual pleasure expressed by subjective orgasmic intensity, and there are no suitable psychometric tools suited to investigate this dimension. Thus, we validate, in female subjects, a Visual Analogue Scale (VAS) that we named Orgasmometer-F, to verify if SD is accompanied by a lower perceived orgasmic intensity. A total of 526 women, recruited through a web-based platform and from sexological outpatient clinic, were enrolled in the study. They were divided into, on the basis of the Female Sexual Function Index (FSFI) score in two groups: 1) 112women suffering from SD, (SD Group); and 2) 414 sexually healthy women (Control Group). The participants were requested to fill out the Orgasmometer-F, recording orgasmic intensity on a Likert scale from 0 (absence of orgasmic intensity) to 10 (maximum orgasmic intensity experienced). Women with SD experienced significantly lower orgasmic intensity than controls, as measured by the Orgasmometer-F (p < 0.0001). Interestingly, masturbatory frequency was positively correlated with orgasmic intensity, as were the lubrication, orgasm and sexual satisfaction domains of the FSFI. The Orgasmometer-F was well understood, had a good test-retest reliability (ICC = 0.93) and a high AUC in differentiating between women with and without sexual dysfunction (AUC = 0.9; p < 0.0001). The ROC curve analysis showed that a cut-off <5 had 86.5% sensitivity (95% CI 82,8–89,6), 80.4% specificity (95% CI 71.8–87.3), 75.4% positive predictive value (PPV) and 89.5% negative predictive value (NPV). In conclusion, the Orgasmometer-F, a new psychometrically sound tool for measuring orgasmic intensity in female population, demonstrated that SD impair orgasmic intensity.
... The last serious problem that will be discussed here is that all the conclusions are based on studies of one group and have, up till now, never been replicated by independent researchers. In a direct attempt to replicate the finding that vaginal intercourse with, but not without additional glans clitoris stimulation is related to immature psychological defenses, 300 women filled out the scale assessing orgasm consistency during various types of partnered-and solo sexual activities, designed by Brody and Costa (2008), as well as the scale they used to measure psychological defense mechanisms. In our sample, orgasm consistency during vaginal intercourse without, but not with, additional glans clitoris stimulation was weakly but significantly positively correlated with immature defense mechanisms (Anthony et al., in preparation). ...
Article
Full-text available
A consistent finding in the literature has been that only about half of the women experiencing orgasm difficulties also report associated distress. This may suggest that orgasms are less important for women's sexual satisfaction than they are for men. Evidence is provided to suggest that orgasms are important for women's sexual satisfaction. The lack of distress seems related to women's lesser consistency of orgasm during partnered sexual activity and not to orgasms being less important per se. In contrast to current suggestions that inability to orgasm during vaginal intercourse points to psychological immaturity, data are presented that imply that women's orgasm consistency in all forms of partnered sexual activity is associated with sexual autonomy (i.e., the extent to which one feels that one's sexual behaviours are self-determined). This paper ends with a brief overview of organic and psychosexual factors associated with problems with sexual excitation and sexual inhibition and reviews evidence-based treatment of anorgasmia. For orgasm problems that are related to problems with sexual excitation, effective treatments are available. We recommend that more effort is given to studying factors associated with sexual inhibition.
... The argument put forward by Freud, that anything other than vaginal orgasm is unhealthy and immature, whilst becoming less prevalent, continues to be promoted more than 100 years later (ibid.). For example, it has been suggested that women who experience vaginal orgasm have better physical and psychological health (Brody et al., 2012;Brody and Costa, 2005). ...
Article
Although some studies of clinical populations suggest an association of adult toy animal ownership with personality disorder, studies of nonclinical populations have been lacking. In a nonclinical young adult sample (N = 148), we found no association of toy animal ownership with use of immature, mature, or neurotic defense mechanisms; avoidant or anxious attachment style; trait conscientiousness; heart rate variability (an index of self-regulatory strength); or social desirability responding. The results do not provide evidence for an association of adult nonclinical toy animal ownership with psychological or psychophysiological indices of immaturity, conscientiousness, insecure attachment, or lack of self-regulatory strength.
Article
Previous research has indicated that men generally rate slimmer women as more sexually attractive, consistent with the increased morbidity risks associated with even mild abdominal adiposity. To assess the association of women's waist size with a more tangible measure of perceived sexual attractiveness (as well as reward value for both sexes), we examined the association of women's age and waist circumference with an index of men's erectile function (IIEF-5 scores), frequency of penile-vaginal intercourse (PVI), and sexual satisfaction in a representative sample of Czechs (699 men and 715 women) aged 35-65 years. Multivariate analyses indicated that better erectile function scores were independently associated with younger age of self and partner and women's slimmer waist. PVI frequency was independently associated with women's younger age and women's slimmer waist. Sexual satisfaction was independently associated with men's younger age and slimmer waist for both sexes. Better erectile function, greater PVI frequency, and greater sexual satisfaction were associated with women's slimmer waist, independently of both sexes' ages. Possible reasons for the waist effects were discussed, including women's abdominal body fat decreasing their own desire through neurohormonal mechanisms and decreasing their partner's desire through evolutionarily-related decreased sexual attractiveness.
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Background As an important source of stress, infertility may affect the quality of sexual life, with extensive studies believing that the incidence of sexual dysfunction in infertile women is highly prevalent. As the years of infertility increase, the greater this stress is likely to increase, which may aggravate psychological pain and cause sexual dysfunction. However, the effect of infertility duration on sexual health is unclear. Methods We performed a case-control study, and a total of 715 patients participated in this research between September 1, 2020, and December 25, 2020. Patients diagnosed with infertility (aged between 20 to 45 years) were included. Patients with infertility were divided into four groups according to infertility duration: ≤ 2 years (Group I, n=262), 2< infertility duration ≤5 years (Group II, n=282), 5 < infertility duration ≤8 years (Group III, n=97), and infertility duration > 8 years (Group IV, n=74). A questionnaire survey of female sexual function and psychological depression of patients with infertility was performed. The female sexual function was measured by the Female Sexual Function Index (FSFI), depression status was measured by the Patient Health Questionnaire (PHQ-9). Results Analysis of the relevant factors that affect sexual function using a multivariable logistic regression model revealed that infertility duration of less than 8 years was not a risk factor for sexual dysfunction. However, when infertility duration was greater than 8 years, the incidence of sexual dysfunction (AOR=5.158,95%CI: 1.935-13.746, P=0.001) and 3 domains [arousal disorder (AOR=2.955 ,95%CI: 1.194-7.314, P=0.019, coital pain (AOR=3.811 ,95%CI: 1.045-13.897, P=0.043), and lubrication disorder (AOR=5.077 ,95%CI: 1.340-19.244, P=0.017)] increases. Conclusions The multivariate regression equation model reveals that the infertility duration is more than 8 years, which is a risk factor for the occurrence of sexual dysfunction. As the infertility duration increases, the incidence of female sexual dysfunction and psychological distress may increase.
Article
This work aims to identify factors that contribute and those that impair the ability to experience orgasm during sexual activity. It compared women (n=96) aged 18-61 (M=38.5 years) in a stable relationship that, after a normal arousal phase, do not have an orgasm (OD) with those that do (OA) regarding sociodemographic data, sexual frequency, talking about sex with their physician, talking about sex with their partner, sexual education, masturbation, sexual desire, sexual satisfaction, depression and anxiety. We found differences between the OD and OA groups with regard to level of education (P=0.022), sex education during childhood and/or adolescence (P<0.001), masturbation (P=0.017), sexual satisfaction (P<0.001), anxiety (P<0.001) and sexual desire (P<0.001). The final model of logistic regression for orgasm problems included the variables 'masturbation', 'high school', 'sexual desire' and 'anxiety'. Orgasm difficulties are influenced by personal factors, such as anxiety and low sexual desire. Increased levels of anxiety also increase orgasmic difficulties. Women who masturbate and/or have completed high school are considerably more likely to reach orgasm during sexual activity.International Journal of Impotence Research advance online publication, 20 March 2014; doi:10.1038/ijir.2014.8.
Conference Paper
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Implementing parallel graph algorithms in large, shared memory machines, such as the Cray XMT, can be challenging for programmers. Synchronization, deadlock, hot spotting, and others can be barriers to obtaining linear scalability. Alternative programming models, such as the bulk synchronous parallel programming model used in Google's Pregel, have been proposed for large graph analytics. This model eases programmer complexity by eliminating deadlock and simplifying data sharing. We investigate the algorithmic effects of the BSP model for graph algorithms and compare performance and scalability with hand-tuned, open source software using GraphCT. We analyze the innermost iterations of these algorithms to understand the differences in scalability between BSP and shared memory algorithms. We show that scalable performance can be obtained with graph algorithms in the BSP model on the Cray XMT. These algorithms perform within a factor of 10 of hand-tuned C code.
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Brody, Costa and Hess (2012) have produced a critique containing errors both of commission and omission of my editorial (Levin 2012a) and review (Levin 2012b). This reply identifies a number of these and makes the appropriate rebuttals and vindications to correct both.
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Prior research indicated that women's greater frequency of sexual activities is associated with perceiving the faces of unknown men as less attractive. In the present study, men aged 18–30 (n = 126) reported the frequency of a variety of sexual behaviors and rated the facial attractiveness and friendliness of 24 women. Unlike the results obtained with women, men's recent sexual behaviors were largely unrelated to perceptions of women's faces and this was the case independent of currently being in a stable relationship. There was no indication of confounding with social desirability responding. Results are discussed as consistent with evolutionary psychology predictions and consistent with men being more likely than women to find others attractive, even when satisfied with their primary intimate relationship.
Article
Die weibliche Orgasmusstörung (,,female orgasmic disorder“, FOD) ist die zweithäufigste Sexualstörung der Frau. Allerdings gibt nur die Hälfte der Frauen an, wirklich darunter zu leiden. Neben dem Orgasmusproblem liegen sehr häufig gleichzeitig andere Sexualprobleme vor. Die umfassende Beurteilung der Orgasmusstörung erfordert deswegen, dass alle relevanten biopsychosozialen Faktoren – im kulturellen Kontext – berücksichtigt werden. Hierzu gehören psychosoziale, kognitive/affektive und Beziehungsfaktoren sowie die Einnahme von Medikamenten, die negativen Einfluss auf die Orgasmusfunktion haben. Die Behandlung der Orgasmusstörung sollte sowohl kognitive als auch verhaltenstherapeutische Interventionen beinhalten. Wenn Orgasmusprobleme nur im Zusammenhang mit dem Partner auftreten, sollte dieser in die Behandlung einbezogen werden. Eine Hormonersatztherapie kann für (postmenopausale) Frauen mit niedrigem Testosteron-/Östrogenspiegel indiziert sein.
Article
Previous research found that frequency of penile-vaginal intercourse (PVI) is associated with better health and satisfaction (sexual, relationship, life, mental health), with some opposite effects for masturbation (even when controlling for partnered sexual activity frequency). Previous research also found that depressed women have a greater desire to masturbate (but not to engage in PVI) than non-depressed women. Thus, we sought to examine if such associations might be due to a characterological issue. Immature psychological defense mechanisms indicate impaired characterological function, and are associated with specific sexual impairments. A sample of 132 women reported their frequencies of various sexual activities, and completed the Defense Style Questionnaire (DSQ-40) and a measure of social desirability responding. Multivariate analyses indicated that immature defense mechanisms are independently associated with (1) greater frequency of engaging in masturbation (beta = .50), younger age, and lower social desirability scores; and (2) greater frequency of desire to engage in masturbation (beta = .48), lesser frequency of desire to engage in PVI (beta = −.21), and younger age. The results should inform the practice of sex education, sex therapy, and understanding of the roles of personality, mood, and sexual behaviors.
Article
Background: Previous research shows that smoking status is unrelated to female sexual difficulties. However, degree of nicotine dependence has not been measured, and the assessment of sexual functioning has not specified penile-vaginal intercourse (henceforth, intercourse), which is more clearly impaired by sexual difficulties than other sexual behaviors. Objectives: To test if smoking status is associated with poorer female sexual function during intercourse, and if nicotine dependence rather than smoking status is related to poorer female sexual function. Methods: During 2012, 129 Portuguese community women reported their smoking status, and completed the Fagerström Test for Nicotine Dependence, the Female Sexual Function Index (FSFI), and an adaptation of the FSFI to assess sexual functioning specifically during intercourse, as well as the desire thereof. Results: Smokers reported higher desire for intercourse and were more likely to have actually engaged in it in the past 4 weeks. Among the coitally active women in the preceding 4 weeks, nicotine dependence correlated with lower desire for intercourse. Smoking status and nicotine dependence were unrelated to arousal, lubrication, orgasm, satisfaction, pain. Conclusions: The findings are consistent with many studies that fail to demonstrate an increased risk of sexual difficulties among female smokers. However, nicotine dependence, rather than smoking status per se, might be associated with lower libido. The results suggest the possibility of an inverse U-shaped relationship between smoking and libido with a moderate use of tobacco being associated with higher sexual desire.
Article
IntroductionThe clitoris is often considered the female version of the penis and less studied compared to its male counterpart. Nonetheless, it carries the same importance in sexual functioning. While it has more recently been allocated the appreciation it deserves, the clitoris should be examined as a separate and unique entity.AimTo review clitoral anatomy, its role in sexual functioning, the controversies of vaginal eroticism and the female prostate, as well as address potential impacts of pelvic surgery on its function.Methods We examined available evidence (from 1950 until 2015) relating to clitoral anatomy, the clitoral role in sexual functioning, vaginal eroticism, female prostate, female genital mutilation/cutting, and surgical implications for the clitoris.Main Outcome MeasuresMain outcomes included an historical review of the clitoral anatomy and its role in sexual functioning, the controversies regarding vaginal sources of sexual function, and the impact of both reconstructive and nonmedical procedures on the clitoris.ResultsThe intricate neurovasculature and multiplanar design of the clitoris contribute to its role in female sexual pleasure. Debate still remains over the exclusive role of the clitoris in orgasmic functioning. Normal sexual function may remain intact, however, after surgical procedures involving the clitoris and surrounding structures.Conclusions The clitoris is possibly the most critical organ for female sexual health. Its importance is highlighted by the fact that the practice of female genital cutting is often used to attenuate the female sexual response. While its significance may have been overshadowed in reports supporting vaginal eroticism, it remains pivotal to orgasmic functioning of most women. Donna Mazloomdoost and Rachel N. Pauls. A comprehensive review of the clitoris and its role in female sexual function. Sex Med Rev **;**:**–**.
Article
This article gives an overview of the development of group psychotherapies in Germany originating from a psychodynamic tradition. The German health system provides access to inpatient and outpatient psychotherapy for all of its citizens. Whereas groups are common in inpatient settings, the provision of outpatient group treatment still could be improved, as it is the case for the general training of group psychotherapists. Group research in Germany largely reflects clinical practice, with more studies coming from the inpatient field. It is stated that the general image of group treatment seems to be largely positive, which could provide a basis for political initiatives to improve the dissemination of group therapy in this country.
Article
Neuropsychoanalytic theories view maladaptive defense mechanisms as disturbances of brain regions or networks implicated in emotional awareness, which is consistent with maladaptive defenses being automatic processes to cope with stressors by avoiding the awareness of disturbing emotions. Freud proposed that defenses against sexual drives were used in varying degrees with negative consequences on sex life, which is congruent with maladaptive defenses being related to lower desire for vaginal intercourse. The present study examined the relationships between low desire, maladaptive defenses, and decoupling of testosterone (T; a hormonal index of sexual desire) from reported desire. Sixty-eight Portuguese women provided a saliva sample before and 15 minutes after an induction of sexual fantasy, and reported how much sexual desire they felt while fantasizing. Maladaptive defenses were measured by the immature defenses subscale of the Defense Style Questionnaire (DSQ-40). Past month desire was assessed by the desire domain of the Female Sexual Function Index. Luminescence immunoassays were used for determining salivary T. Decoupling of T from desire was calculated by the absolute value of the subtraction of the standardized scores of both measures. In partial correlations controlling for social desirability and oral contraception, maladaptive defenses correlated with discordance between basal T and fantasy-induced desire, discordance between basal T and past month desire, and complaints of low desire. In a backward multiple regression, discordance between T and past month desire explained the association between maladaptive defenses and complaints of low desire. Implications for future neuropsychoanalytic studies of defense mechanisms and libido are discussed.
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Introduction: Most women report that clitoral stimulation is an integral aspect of their orgasm experience. Thus, recent claims that vaginal stimulation and vaginally generated orgasms are superior to clitoral stimulation and clitorally generated orgasms pathologize most women and maintain a clitoral vs vaginal dichotomy that might not accurately reflect the complexity of women's sexual experience. Aim: To have women report on their experienced source of orgasm, including combinations of vaginal and clitoral stimulation, the solo or partnered context of the stimulation, and the intensity of the orgasms from different sources and to predict indicators of mental health and sexual health using the orgasm source. Methods: Eighty-eight women 18 to 53 years old answered detailed questions about their usual and recent orgasm experiences, sexual history, depression, and anxiety. Then, they viewed a series of neutral and sexual films. They were instructed to increase or decrease their sexual arousal or respond "as usual" to the sexual films. They reported their sexual arousal after each film. Main outcome measures: Outcomes assessed included mental health (depression and anxiety) and sexual health (orgasm quality, ability to regulate sexual response to sex films). Reported sexual arousal was analyzed for the regulation task. Results: Most women (64%) reported that clitoral and vaginal stimulation contributed to their usual method of reaching orgasm. Women who reported that clitoral stimulation was primarily responsible for their orgasm reported a higher desire to self-stimulate and demonstrated greater control over their self-reported sexual arousal. The primary stimulation site for orgasm was unrelated to measurements of depression or anxiety despite sufficient statistical power. Conclusion: Most women reported that clitoral and vaginal stimulation is important in orgasm. Women experience orgasms in many varied patterns, a complexity that is often ignored by current methods of assessing orgasm source. The reported source of orgasm was unrelated to orgasm intensity, overall sex-life satisfaction, sexual distress, depression, or anxiety. Women who reported primarily stimulating their clitoris to reach orgasm reported higher trait sexual drive and higher sexual arousal to visual sexual stimulation and were better able to increase their sexual arousal to visual sexual stimulation when instructed than women who reported orgasms primarily from vaginal sources.
Chapter
This chapter analyzes why societies put so much emphasis on virginity. In many cultures virginity has historically been tied to purity and morality, especially for women. In the early 1900s, however, this view began to change. Though virginity was still seen as valuable to women, more young women were more willing to have sex outside of marriage—especially within the context of a relationship that was heading toward marriage. The 1990s were an interesting time for views on virginity. In modern history, society has had some pretty conflicting views on virginity. These views impact how individuals feel about their own first time. The chapter highlights that young people should be educated about sexuality and first sexual experiences before they have them. It further talks about the simultaneous orgasm myth, gender, rough sex, masturbation and aphrodisiacs.
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This study examined whether lesbian and heterosexual women differ in the likelihood of experiencing an orgasm during partnered sexual activity, and whether that would possibly be related to differences in stimulation of the glans clitoris. Orgasm consistency was defined as the likelihood with which orgasm occurs during sexual activity. In an online questionnaire, participants were asked to indicate how often their partner engaged in various sexual acts (with glans clitoral or penetrative vaginal stimulation) and how often orgasms occured during these acts. Also, the role of vaginal and clitoral selfstimulation during partnersex was examined. Sexual acts in which the partner stimulated the glans clitoris, were more likely to result in orgasm than penetrative stimulation of the vagina (by fingers, object, or penis), irrespective of sexual orientation. Lesbian women had a greater orgasm consistency during sexual activity with a partner than heterosexual women. They were also more likely to be clitorally, and less likely to be vaginally stimulated by their partner. As expected, there were no differences in orgasm consistency between lesbian and heterosexual women with selfstimulation during partner sex. Additionally, lesbian women were more sexually autonomous than heterosexual women, and sexual autonomy was positively related to orgasm consistency. Also, average lesbian lovemaking lasted longer than average heterosexual lovemaking. This study demonstrated that lesbian women orgasm more consistently during partnersex than heterosexual women. Type of stimulation and frequency of these activities during partnersex appears to be largely responsible for these differences in orgasm consistency.
Article
The review critically examines two functional claims involving the human female orgasm. The first is that it is involved in the transport of spermatozoa by its release of oxytocin to create uterine contractions that suck up more semen at a faster rate. There is no physiological evidence for this scenario and the published experimental studies with oxytocin do not mimic the conditions of natural coitus. There is no evidence that orgasm has a role to play in reproductive fitness. The second claim is that as penile-vaginal intercourse (PVI) and its induced orgasm is the only sexual arousal that involves possible reproduction, evolution has rewarded it, and not clitorally-induced arousal (which it punishes), with highly specific health rewards. Apparently these cannot be generated by clitoral stimulation, moreover, its employment previous to and even at the same time as PVI negates these health advantages. The studies rely not only on women's retrospective self-reports of the genital structures creating their orgasms, which are known to have an “ambiguity problems”, but also on correlations from which causality is claimed or inferred. They have not been confirmed by independent researchers. Despite all women having the same genital structures from which sexual arousal is generated and that orgasm is not involved in reproduction via sperm transport, it is more than surprising that evolution has apparently created a situation where the majority of women do not or cannot generate orgasms from PVI alone and are thus imbued with poorer physical and mental health. This is even more unexpected when it is known that PVI actually stimulates the clitoris through thrusting traction on its attached ligaments via the anterior vaginal wall.
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KILMARTIN (1994) suggested that masculine traits may result from externalizing defense style and that when unconscious and unwanted feminine traits about the self occur, they are dealt with in an external way, radier man being directiy resolved by the individual. However, this dieory has received little empirical support. Lobel and Winch (1986) measured defense style among male college students; they found mat men who scored higher in masculinity tended to score higher on acting out (finding an object to attack) and splitting (separating affect from content). Lobel and Winch concluded mat use of diese defense styles reflects avoidance of emotional expression. In turn, diese findings have been supported by research that has suggested mat men use avoidance coping strategies more man women do (McCall & Struthers, 1994).
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Objectives: To explore, in an age perspective, women's lifetime sexual techniques and the extent to which they had led to orgasm. To relate these techniques and current erotic perceptions to orgasmic function in women sexually active during the last 12 months and to describe the relative impact of orgasmic function/dysfunction on their sexual well-being. Methods: A nationally representative sample of 18- to 74-year-old women (N = 1,335) participated. Nearly all were heterosexual. Current orgasmic capacity was broadly and subjectively classified into: no, mild, or manifest dysfunction. Sexual techniques and erotic perceptions were recorded together with level of sexual satisfaction. Results: Generational differences characterized age at first orgasm and intercourse, types and width of sexual repertoire, and also current erotic perceptions, while orgasmic dysfunction and distress caused by it were less age dependent. Likely protectors of good orgasmic function, mainly against manifest dysfunction, were: a relatively early age at first orgasm, a relatively greater repertoire of techniques used--in particular having been caressed manually or orally by partner(s), achievement of orgasm by penile intravaginal movements, attaching importance to sexuality and being relatively easily sexually aroused. In turn, among other aspects of female sexual function women who did not have orgasmic dysfunction or distress were particularly likely to be satisfied with their sexual life. Conclusion: Besides providing data on matters frequently said to be sensitive this investigation shows that women's generation and with it several long-ranging aspects of women's sexual history and their feelings of being sexual are important indicators of their orgasmic and thereby their overall sexual well-being. When (in clinical practice) establishing treatment strategy for women with orgasmic dysfunction due respect should be given to these factors.
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In Brazil, treatment of panic disorder is most frequently initiated with pharmacotherapy, but only half of the patients can be expected to be panic free after medication. Studies have suggested that individual or group cognitive-behavior therapy (CBT) is an effective treatment strategy for panic patients who have failed to respond to pharmacotherapy. Thirty-two patients diagnosed with panic disorder with agoraphobia having residual symptoms despite being on an adequate dose of medication were treated with 12 weeks of group CBT. The outcome was evaluated for panic frequency and severity, generalized anxiety, and global severity. Comorbid conditions, a childhood history of anxiety, and defense mechanism styles were assessed as potential predictors of treatment response. Twenty-nine patients completed the 12-week protocol. Treatment was associated with significant reductions in symptom severity on all outcome measures (p < 0.001). Patients with depression had a poorer outcome of the treatment (p = 0.01) as did patients using more neurotic (p = 0.002) and immature defenses (p = 0.05). Consistent with previous reports, we found that CBT was effective for our sample of treatment-resistant patients. Among these patients, depression as well as neurotic defense style was associated with a poorer outcome. The use of CBT in Brazil for treatment-resistant and other panic patients is encouraged.
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We conducted an exploratory study comparing 47 college-aged women reporting depressive symptoms but not receiving antidepressant medication to 47 age-matched controls. We examined various dimensions of sexual functioning, including sexual desire, arousal, orgasm, pain, pleasure, and satisfaction. The women with depressive symptoms reported more inhibited sexual arousal, more inhibited orgasm, more sexual pain problems, and less sexual satisfaction and pleasure than control participants. Novel to this study, the women with depressive symptoms reported greater desire for sexual activity alone (masturbation) than the nondepressed women. The findings are discussed in terms of primary reinforcers and depressive symptomology.
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Women diagnosed with complete spinal cord injury (SCI) at T10 or above report vaginal-cervical perceptual awareness. To test whether the Vagus nerves, which bypass the spinal cord, provide the afferent pathway for this response, we hypothesized that the Nucleus Tractus Solitarii (NTS) region of the medulla oblongata, to which the Vagus nerves project, is activated by vaginal-cervical self-stimulation (CSS) in such women, as visualized by functional magnetic resonance imaging (fMRI). Regional blood oxygen level-dependent (BOLD) signal intensity was imaged during CSS and other motor and sensory procedures, using statistical parametric mapping (SPM) analysis with head motion artifact correction. Physiatric examination and MRI established the location and extent of spinal cord injury. In order to demarcate the NTS, a gustatory stimulus and hand movement were used to activate the superior region of the NTS and the Nucleus Cuneatus adjacent to the inferior region of the NTS, respectively. Each of four women with interruption, or "complete" injury, of the spinal cord (ASIA criteria), and one woman with significant, but "incomplete" SCI, all at or above T10, showed activation of the inferior region of the NTS during CSS. Each woman showed analgesia, measured at the fingers, during CSS, confirming previous findings. Three women experienced orgasm during the CSS. The brain regions that showed activation during the orgasms included hypothalamic paraventricular nucleus, medial amygdala, anterior cingulate, frontal, parietal, and insular cortices, and cerebellum. We conclude that the Vagus nerves provide a spinal cord-bypass pathway for vaginal-cervical sensibility in women with complete spinal cord injury above the level of entry into spinal cord of the known genitospinal nerves.
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The aim of this study is to describe the translation and adaptation process of the Defense Style Questionnaire (DSQ-40) into Brazilian-Portuguese version. The instrument has also contended validation evaluation. The first version of the scale was presented to five individuals with different schooling for language adaptation. Afterwards the instrument was presented to three experts that evaluated its content validation. The final version was back-translated and accepted by the original author. Vocabulary adjustments were needed in 9 items and language adaptation in 4 items in order to render the final DSQ-40 Brazilian-Portuguese version. The mean of experts' correlation to each defense was 89%, being 100% to mature, neurotic and immature factors. The adaptation of DSQ-40 by different individuals and the group of experts enabled the necessary adjustment to the Brazilian socio-cultural reality.
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This study reports on genetic and environmental influences on the frequency of orgasm in women during sexual intercourse, during other sexual contact with a partner, and during masturbation. Participants were drawn from the Australian Twin Registry, and recruited from a large, partly longitudinal twin-family study. Three thousand and eighty women responded to the anonymous self-report questionnaire, including 667 complete monozygotic (MZ) pairs and 377 complete dizygotic (DZ) same-sex pairs, 366 women from complete DZ opposite-sex pairs, and 626 women whose co-twins did not participate. Significant twin correlations were found for both MZ and DZ twin pairs for all three items of interest. Age effects were statistically significant for some items. Models incorporating additive genetic, shared and nonshared environmental influences provided the best fit for Items 1 and 3, while a model with additive and nonadditive genetic influences along with nonshared environment fitted the data from Item 2. While an independent pathway model fits the data most par-simoniously, a common pathway model incorporating additive genetic (A), shared environment (C), and unique environment (E) effects cannot be ruled out. Overall, genetic influences account for approximately 31% of the variance of frequency of orgasm during sexual intercourse, 37% of the variance of frequency of orgasm during sexual contact other than during intercourse, and 51% of the variance of frequency of orgasm during masturbation. Following Baker (1996), we speculate that this additive genetic variance might arise from frequency-dependent selection for a variety of female sexual strategies.
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We previously reported on the causes of death in a 30-year open cohort of 1,969 prostitute women. Excess mortality was mostly accounted for by homicide, suicide, drug and alcohol toxicity, and AIDS, with AIDS deaths occurring in prostitutes identified as injecting drug users. Presently, we examine observed mortality trends in light of the literature on personality and psychopathological characteristics reported for prostitute women, and with reports linking such personality characteristics to excess mortality. We observed consistency between the observed pattern of mortality in prostitute women and mortality that would be expected in a sample of persons at high risk for antisocial and borderline personality disorder.
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Research indicates that prolactin increases following orgasm are involved in a feedback loop that serves to decrease arousal through inhibitory central dopaminergic and probably peripheral processes. The magnitude of post-orgasmic prolactin increase is thus a neurohormonal index of sexual satiety. Using data from three studies of men and women engaging in masturbation or penile-vaginal intercourse to orgasm in the laboratory, we report that for both sexes (adjusted for prolactin changes in a non-sexual control condition), the magnitude of prolactin increase following intercourse is 400% greater than that following masturbation. The results are interpreted as an indication of intercourse being more physiologically satisfying than masturbation, and discussed in light of prior research reporting greater physiological and psychological benefits associated with coitus than with any other sexual activities.
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Orgasm is a sensation of intense pleasure creating an altered consciousness state accompanied by pelvic striated circumvaginal musculature and uterine/anal contractions and myotonia that resolves sexually-induced vasocongestion and induces well-being/contentment. In 1,749 randomly-sampled U.S. women, 24% reported an orgasmic dysfunction. To provide recommendations/guidelines concerning state-of-the-art knowledge for management of orgasmic disorders in women. An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. Concerning the Disorders of Orgasm in Women Committee, there were four experts from two countries. Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate. Female Orgasmic Disorder, the second most frequently reported women's sexual problem is considered to be the persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase that causes marked distress or interpersonal difficulty (DSM-IV). Empirical treatment outcome research is available for cognitive behavioral and pharmacological approaches. Cognitive-behavioral therapy for anorgasmia promotes attitude and sexually-relevant thought changes and anxiety reduction using behavioral exercises such as directed masturbation, sensate focus, and systematic desensitization treatments as well as sex education, communication skills training, and Kegel exercises. To date there are no pharmacological agents trials (i.e., bupropion, granisetron, and sildenafil) proven to be beneficial beyond placebo in enhancing orgasmic function in women diagnosed with Female Orgasmic Disorder. More research is needed in understanding management of women with orgasmic dysfunction.
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This study examined the influence of distraction on genital and subjective sexual responses of women with (N=20) and without (N=21) sexual problems. Female-produced erotic film fragments were presented to induce sexual response and a vaginal photoplethysmograph was used to measure genital sexual responding. Subjective sexual arousal was assessed in real time using a rotating button and, retrospectively, with visual analogue scales. Distraction load was manipulated through different verbal instructions on how to deal with pairs of digits. The results revealed an equally strong impeding effect of distraction on genital sexual responses and on subjective sexual responses when these were measured retrospectively in women with and without sexual problems. However, distraction did not affect subjective sexual responses when these were measured in real time. The implications of the finding that distraction equally affects women with and without sexual problems are discussed.
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This study investigates the prevalence of current somatization in the population by taking different levels of symptom severity into account. Somatization is described along a continuum from mild and negligible bodily misperceptions to severe and disabling somatoform symptoms. A representative sample of 2.552 persons in Germany was examined with a screening instrument for medically unexplained physical complaints that had occurred during the past 7 days. All 53 symptoms from the ICD-10/DSM-IV sections of somatoform disorders were included. 81.6% reported at least one symptom causing at least mild impairment and 22.1% at least one symptom causing severe impairment. The entire sample had an average of 6.6 symptoms associated with at least mild distress. Somatization of any degree was associated with female gender, age above 45, lower educational level, lower household income and rural area. The most common symptoms with prevalence rates > 20% were various types of pain (back, head, joints, extremities), food intolerance, sexual indifference, painful menstruations and erectile/ejaculatory dysfunction. This population survey demonstrates that medically unclear complaints are an everyday phenomenon. About three out of four cases are below clinical relevance with only low level of impairment. Epidemiological correlates are similar between clinical and non-clinical forms of somatization.
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THE FACT of differential sexual responsiveness in women has been widely discussed; and there are a number of theoretical formulations concerning the factors contributing to the ability to achieve satisfactory sexual experience. It is within the psychoanalytic literature that one finds the most explicit concern with this matter and also the most elaborate attempts to offer meaningful explanatory concepts. In accordance with Freud's formulations1,2 it is assumed that the ability to obtain satisfaction from intercourse is a function of personal maturity. The view is taken that if a woman successfully copes with pregenital problems and resolves her oedipal conflicts satisfactorily, she then becomes capable of achieving genitality, which is equated with the highest form of maturity. She manifests this in the ability to achieve satisfaction and orgasm via a "normal" sexual relationship. One should note that in the freudian scheme real genitality
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The aim of this study is to analyze the reliability and validity of the Brazilian–Portuguese version of the Defensive Style Questionnaire (DSQ). Participants were evaluated by clinical interview and the Mini-International Neuropsychiatric Interview. Reliability was assessed by factor analysis and Cronbach's alpha. The 3-factor model's replication was tested using confirmatory factor analysis (CFA). Controls were reevaluated after 4 months to assess test–retest reliability. Subsamples were also evaluated using the Minnesota Multiphasic Personality Inventory and Defensive Functioning Scale (DFS). Factor analysis of the various defense mechanisms produced a distribution of mechanisms among the factors that was largely similar to previous analyses based on the original instrument. The 3-factor model was supported by CFA. The test–retest evaluation showed sufficient intraclass correlation for all factors. Patients used more immature and neurotic defenses than controls. There was a correlation between DFS and immature defenses. Individuals with pathological personality traits scored higher on the immature and neurotic factors than those without. The Brazilian–Portuguese version of the DSQ-40 has psychometric features that allow the use of this instrument in our culture.
Article
In a large representative sample of the Swedish female adult population (N = 1256), having an orgasm from purely penile stimulation of the vagina (as opposed to orgasms from clitoral stimulation) was associated with greater satisfaction (with sex life, mental health, relationships with both partners and friends, and life in general), more frequent sexual desire, greater likelihood of having one's first ever orgasm from intercourse rather than masturbation, and lesser recent masturbation frequency. The association of vaginal orgasm with these measures was unconfounded by a marginal association of vaginal orgasm with frequency of vaginal intercourse (which was independently associated with most of the measures of greater satisfaction). Vaginal orgasms were not associated with having had orgasms from partner masturbation or cunnilingus. The results are discussed in terms of recent advances in sexual physiology showing different pathways for vaginal versus clitoral sensation and orgasm, other empirical research showing psychological and physiological advantages of penile – vaginal intercourse over other sexual behaviours, psychoanalytic theory, and the need to overhaul the practices of sex therapy and sex education.
Article
This research tested three models of how the relationship evaluation components of satisfaction, commitment, intimacy, trust, passion, and love a structured and cognitively represented. Participants in Study 1 rated their intimate relationships on six previously developed scales that measured each construct and on a new inventory-the Perceived Relationship Quality Components (PRQC) Inventory. As predicted, confirmatory factor analysis revealed that, for both sets of scales, the best-fitting model was one in which the appropriate items loaded reliably on the six first-order factors, which in turn loaded reliably on one second-order factor reflecting overall perceived relationship quality. These results were replicated on a different sample in Study 2 and across sex. Implications and advantages of the PRQC Inventory are discussed.
Article
Three short forms of the Marlowe-Crowne Social Desirability Scale were constructed from the results of principal components analysis (N = 399). Those subscales were compared with short forms developed by previous researchers who used the same methodology. Examination of the subscales indicated that 13 of the scale's 33 items were isolated by at least two of the three reported studies. Those items were used to construct a composite subscale, which appeared to offer a useful alternative to the full scale. Further analysis of the subscale's contents, however, raised questions about the dimensionality of the Marlowe-Crowne scale. Caution was urged in the use and interpretation of both the full inventory and the short form until the meaning of scale scores can be clarified.
Article
Using a structured interview and four questionnaires we examined the sexual development and life in the following groups of psychiatric female patients: 51 with schizophrenia, 50 with manic-depressive psychoses, 50 with neuroses, 30 with hysterical psychopathic personality, and 20 with anorexia nervosa. The results were compared with a control group of 101 gynecological spa patients. The sexual development of the schizophrenic patients was found to be retarded, whereas that of the patients with anorexia nervosa accelerated in the initial stages. The sexual development of patients with hysterical personality was found to be disharmonious. No differences were found between patients with manic-depressive psychoses and the control group as far as the sex life in adulthood is concerned. However, all the other groups of psychiatric patients showed decreased sexual activity and/or reactivity. Sexual dysfunctions in the female psychiatric population are frequent, especially with schizophrenic patients, females with anorexia nervosa, and with hysterical personality. The etiological factors responsible for these sex disturbances are different in the individual groups of psychiatric patients.
Article
Questionnaire data regarding mode of sexual stimulation were collected in 200 women treated for neurotic disorders and 100 female health professionals and counselors. Clitoral stimulation was the source of female orgasm in 90% of subjects, while three quarters achieved orgasm also by means of vaginal stimulation. The anterior wall of the vagina seemed to be slightly more important than the posterior one. One third of the respondents reported effective stimulation in the depth of the vagina with cervical tapping. Stimulation in the area corresponding to the alleged G spot was acknowledged as effective by 10 to 20%. The sexual responsiveness of neurotic patients was generally somewhat lower than responsiveness of health professionals and counselors.
Article
The Defense Style Questionnaire has proven of interest as the first questionnaire to reliably describe defense styles. The 72-item DSM-III-R-labeled Defense Style Questionnaire was administered to 388 controls and 324 patients. Eight statistical and two a priori criteria were used in choosing two items to represent each of the 20 defenses. A new 40-item Defense Style Questionnaire is published together with normative and reliability data on a normal population, patients with anxiety disorders, and child-abusing parents. The scores are unaffected by the sex of the respondent, but the endorsement of immature defense styles decreases with age.
Article
The Coital Alignment Technique (CAT), a basic physiological alignment that provides consistent and effective stimulation for female coital orgasm, has been evaluated in a series of controlled studies. An overview of the CAT is discussed as well as related studies including replication studies, and subsequent studies of Orgasm Consistency Training (OCT), which incorporates the CAT technique. Classic sex problems like female coital anorgasmia and premature ejaculation and modern day epidemic-level sex problems such as hypoactive sexual desire are analyzed in relation to a syndrome of sexual dysfunction symptoms devolving from failed intercourse. Studies indicate that some symptoms of sexual dysfunction considered to have their etiological foundations in pathology are the result of ineffective intercourse techniques.
Article
Our recent research provides evidence that women with complete spinal cord injury (SCI) at the midthoracic level show perceptual responses to vaginal and/or cervical self-stimulation (for example, pain suppression and sexual response, including orgasm). On the basis of studies in laboratory rats, we hypothesized that the vagus nerves provide a sensory pathway from the vagina, cervix, and uterus directly to the brain in women. To test this hypothesis, we performed a PET-MRI study on two women with complete SCI and 1 woman with no injuries. Whereas control foot stimulation of the women with SCI did not activate the somatosensory thalamus, cervical self-stimulation increased activity in the region of the nucleus of the solitary tract, which is the brainstem nucleus to which the vagus nerves project. These preliminary findings suggest that the vagus nerves can convey genital sensory input directly to the brain in women, completely bypassing SCI at any level.
Article
To examine the association between female genital cutting and frequency of sexual and gynaecological symptoms among a cohort of cut versus uncut women in Edo State of Nigeria. Cross sectional study. Women attending family planning and antenatal clinics at three hospitals in Edo State, South-south Nigeria. 1836 healthy premenopausal women. The sample included 1836 women. Information about type of female genital cutting was based on medical exams while a structured questionnaire was used to elicit information on the women's sociodemographic characteristics, their ages of first menstruation (menarche), first intercourse, marriage and pregnancy, sexual history and experiences of symptoms of reproductive tract infections. Associations between female genital cutting and these correlates of sexual and gynaecologic morbidity were analysed using univariate and multivariate logistic regression and Cox models. Frequency of self-reported orgasm achieved during sexual intercourse and symptoms of reproductive tract infections. Forty-five percent were circumcised and 71% had type 1, while 24% had type 2 female genital cutting. No significant differences between cut and uncut women were observed in the frequency of reports of sexual intercourse in the preceding week or month, the frequency of reports of early arousal during intercourse and the proportions reporting experience of orgasm during intercourse. There was also no difference between cut and uncut women in their reported ages of menarche, first intercourse or first marriage in the multivariate models controlling for the effects of socio-economic factors. In contrast, cut women were 1.25 times more likely to get pregnant at a given age than uncut women. Uncut women were significantly more likely to report that the clitoris is the most sexually sensitive part of their body (OR = 0.35, 95% CI = 0.26-0.47), while cut women were more likely to report that their breasts are their most sexually sensitive body parts (OR = 1.91; 95% CI = 1.51-2.42). Cut women were significantly more likely than uncut women to report having lower abdominal pain (OR = 1.54, 95% CI = 1.11-2.14), yellow bad-smelling vaginal discharge (OR = 2.81, 95% CI = 1.54-5.09), white vaginal discharge (OR = 1.65, 95% CI = 1.09-2.49) and genital ulcers (OR = 4.38, 95% CI 1.13-17.00). Female genital cutting in this group of women did not attenuate sexual feelings. However, female genital cutting may predispose women to adverse sexuality outcomes including early pregnancy and reproductive tract infections. Therefore, female genital cutting cannot be justified by arguments that suggest that it reduces sexual activity in women and prevents adverse outcomes of sexuality.
Article
Many studies have found a discordance between women's genital (vaginal pulse amplitude) and subjective sexual arousal responses to erotica. We hypothesized that the association between the physiological and subjective domains would be greater for women with greater orgasmic consistency during penile-vaginal intercourse but not for orgasm consistency during other sexual behaviors. We confirmed this specific hypothesis in a sample (N = 38) of postmenopausal women. In addition, we discovered that the correlation between the domains was unrelated to social desirability responding, that orgasm consistency was not less for intercourse than for other sexual activity, and that orgasm consistency during intercourse was uncorrelated with orgasm consistency during masturbation. We discuss the results in terms of the unique nature of penile-vaginal intercourse, our study's implications for sex therapy, and orgasm consistency during intercourse being an operational measure of functional vaginal sensitivity and sexual pleasure integration and organization.
Article
We examined the relationship between recalled and diary recorded frequency of penile-vaginal intercourse (FSI) and both resting heart rate variability (HRV; an index of cardiac autonomic control and parasympathetic tone associated with cardiovascular health outcomes) and resting diastolic blood pressure (DBP) in 120 healthy adults aged 19-38 (subjects scoring above the 87th percentile on the Lie scale of the Eysenck Personality Inventory were excluded from analyses). As in a previous smaller study, greater HRV was associated with greater FSI (but not masturbation or non-coital sex with a partner) and rated importance of intercourse. There were no sex differences in the HRV-FSI relationship, and the relationship was not explained by including measures of Extraversion, Neuroticism, Depression, Trait Anxiety, or partnership satisfaction. However, the previously obtained negative association of FSI with DBP was not replicated.
Article
This study examined 1) whether patients with chronic and recurrent anxiety and depressive disorders and/or personality disorders demonstrate improvement in their defense styles with long-term dynamic psychotherapy and 2) what the relationship is between defense style change and symptomatic change. Measures of defense (Defense Style Questionnaire) and symptoms and functioning were administered at regular intervals over the course of 3-5 years to adults who entered a naturalistic study of long-term psychodynamic psychotherapy. With hierarchical linear regression, the relative contributions of change in variables on the Defense Style Questionnaire to change in other outcome variables were calculated. Those with high initial scores on the maladaptive and self-sacrificing defense styles improved, with effect sizes of 0.80 and 0.67, while overall defensive functioning improved, with an effect size of 0.43. The effect size of the change in score on the Global Assessment of Functioning scale was 0.82. Depressed subjects improved their scores significantly on the Hamilton Depression Rating Scale, and there was a significant improvement in distress, as measured by the SCL-90-R. Changes in score on the Defense Style Questionnaire added substantially to the prediction of variance in these three outcomes above their initial levels. A higher level of defensive functioning also predicted a better self-reported therapeutic alliance. Defense styles became more adaptive and symptoms improved over time in patients who started with scores in the clinical range. Change in defense style predicts symptomatic change, but causation has not been established.
Article
We examined the association between lifetime depression history and sexual function in a community-based sample of midlife women. Specifically, 914 women aged 42-52 who were participants in the Study of Women's Health Across the Nation completed a self-report assessment of their sexual behaviors, sexual desire, sexual arousal, and sexual satisfaction over the past 6 months. On the basis of the Structured Clinical Interview for the DSM-IV , participants were categorized into 1 of 3 lifetime major depressive disorder (MDD) history groups: no MDD history, single episode MDD, and recurrent MDD. In line with previous reports, women with a history of recurrent MDD reported experiencing less frequent sexual arousal, less physical pleasure, and less emotional satisfaction within their current sexual relationships. Although the groups did not differ in their reported frequency of sexual desire or partnered sexual behaviors, lifetime depression history was associated with increased rates of self-stimulation (masturbation). Associations between lifetime depression history and lower levels of physical pleasure within partnered sexual relationships and higher rates of masturbation remained significant following control for current depressive symptoms, study site, marital status, psychotropic medication use, and lifetime history of anxiety or substance abuse/dependence disorder. Future research is needed to characterize the temporal and etiologic relationships among lifetime depressive disorder, current mood state, and sexual function in women across the lifespan.
Article
The Defense Style Questionnaire (DSQ) is a widely used self-report measure of empirically derived groupings of defense mechanisms ranked on an adaptive hierarchy. A review of published studies indicates strong evidence that adaptiveness of defense style correlates with mental health and that some diagnoses are correlated with specific defense patterns-for example, borderline personality disorder with greater use of both maladaptive and image-distorting defenses and less use of adaptive defenses. For other diagnoses, the pattern of defenses is less clear but often reinforces theoretical formulations. Defense styles become more adaptive with improvement in symptoms, but intermediate defenses tend to be stable (traitlike) over time. Defenses are sometimes predictive of the quality of the therapeutic alliance. Although one might speculate that assessment of defenses can be useful in planning treatment, there are no studies supporting this hypothesis.
Article
Penile-vaginal intercourse (PVI) but not other sexual behavior is associated with better psychological and physiological function. I examined the relationship of sexual behavior patterns to blood pressure (BP) and its reactivity to stress (public speaking and verbal arithmetic). For a fortnight, 24 women and 22 men used daily diaries to record PVI, masturbation, and partnered sexual behavior in the absence of PVI. Persons who reported PVI (but no other sexual activities) had better stress response (less reactivity and/or lower baseline levels) than persons reporting other or no sexual behaviors. Persons who only masturbated or had partnered sex without PVI had 14 mmHg more systolic BP reactivity than those who had PVI but not the other behaviors. Many variables were examined but failed to confound the observed relationships. The magnitude of the sexual behavior effect on BP reactivity is greater than of other factors in the literature. These findings add to the research corpus on the benefits of PVI (differentiated from other sexual activities).
Article
The effort to determine the global burden of premature ejaculation (PE) has been impeded by the lack of a clear and universally accepted definition of the condition. Current diagnostic criteria are variable and rely, to a large degree, on subjective measurements. Moreover, the absence of a clear consensus on what constitutes a normal ejaculatory latency has impeded research into the prevalence of PE, although evidence is gradually accruing that may make this definition easier. Perception of "normal" ejaculatory latency varies by country and can differ when assessed either by the patient or their partner. Despite these limitations, information from the Global Study of Sexual Attitudes and Behaviors and other sources suggests a global prevalence of PE of approximately 30% across all age groups. The etiology underpinning this prevalence remains to be clarified, but current evidence reflects a shift from psychogenic theories to more neurobiological bases. While elucidation of the etiology of PE will undoubtedly aid the development of more effective therapies, it is clear that, whatever the cause of the condition, it is associated with a significant burden on psychological and overall health.
Article
Psychological treatment studies, uncontrolled for ego defense (adaptive) styles, report conflicting survival results. The authors hypothesized that "immature" adaptive styles and frequent depression symptoms would independently predict lower survival rates. This study followed 86 consecutive, mostly late-stage, cancer outpatients for up to 5 years; their survival data were analyzed in relation to the Beck Depression Inventory and the Defense Style Questionnaire scores at study entry. Cumulative survival probability curves contrasted the extreme cases: the most (N=15) to the least (N=21) depressed, and the "immature" (N=14) to the "mature" (N=16) adaptors. Depression did not separate the groups until 30 months after diagnosis. Ego defense style separated them at 8 months; by 18 months, the "immature" survival probability had dropped to 50%, versus 87% for the "mature." At 36 months, survival probabilities were 19% and 57%, respectively. These data direct clinical attention toward ego defense mechanisms as indicators of distress and lowered survival in cancer patients. They further suggest that the maturity of adaptive mechanisms must be controlled for in behavioral-treatment trials of cancer patients.
Article
The aim of this study was to assess the impact of psychological distress and personality traits on self-rated compliance with glaucoma treatment. One hundred patients with primary open-angle glaucoma participated in the study. General Health Questionnaire, Symptom Distress Checklist, Center for Epidemiological Studies Depression Scale, Defense Style Questionnaire, and Hostility and Direction of Hostility Questionnaire were used. Forty-two percent of patients with glaucoma classified as "noncompliers," those who omitted more than two doses per week. Noncompliers presented more severe symptoms of glaucoma. Depression was found to be associated with poor compliance, whereas adoption of immature defensive style further increased the risk for noncompliance with glaucoma treatment. Depression is associated with self-reported noncompliance with glaucoma treatment, whereas certain personality traits are involved in the increased risk for noncompliance. Further assessment of the depressive feelings by an ophthalmologist and treatment of depression as well as proper psychotherapeutic approaches for maladaptive personality features could be an essential strategy to diminish compliance problems.
Article
Women possess sufficient vaginal innervation such that tactile stimulation of the vagina can lead to orgasm. However, there are few anatomic studies that have characterized the distribution of nerves throughout the human vagina. The aim of this prospective study was to better characterize the anatomic distribution of nerves in the adult human vagina. A secondary aim was to assess whether vaginal innervation correlates with the subject's demographic information and sexual function. Full-thickness biopsies of anterior and posterior vagina (proximal and distal), cuff, and cervix were taken during surgery in a standardized manner. Specimens were prepared with hematoxylin and eosin, and S100 protein immunoperoxidase. The total number of nerves in each specimen was quantified. Enrolled patients completed a validated sexual function questionnaire (Female Sexual Function Index, FSFI) preoperatively. A description of vaginal innervation by location and an assessment of vaginal innervation in association with the subject's demographic information and sexual function. Twenty-one patients completed this study, yielding 110 biopsy specimens. Vaginal innervation was somewhat regular, with no site consistently demonstrating the highest nerve density. Nerves were located throughout the vagina, including apex and cervix. No significant differences were noted in vaginal innervation based on various demographic factors, including age, vaginal maturation index, stage of prolapse, number of vaginal deliveries, or previous hysterectomy. There were no correlations between vaginal nerve quantity and FSFI domain and overall scores. Fifty-seven percent of the subjects had female sexual dysfunction; when compared to those without dysfunction, there were no significant differences in total or site-specific nerves. In a prospective study, vaginal nerves were located regularly throughout the anterior and posterior vagina, proximally and distally, including apex and cervix. There was no vaginal location with increased nerve density. Vaginal innervation was not associated with demographic information or sexual function.
Article
Orgasmic dysfunction in females is commonly reported in the general population with little consensus on its aetiology. We performed a classical twin study to explore whether there were observable genetic influences on female orgasmic dysfunction. Adult females from the TwinsUK register were sent a confidential survey including questions on sexual problems. Complete responses to the questions on orgasmic dysfunction were obtained from 4037 women consisting of 683 monozygotic and 714 dizygotic pairs of female twins aged between 19 and 83 years. One in three women (32%) reported never or infrequently achieving orgasm during intercourse, with a corresponding figure of 21% during masturbation. A significant genetic influence was seen with an estimated heritability for difficulty reaching orgasm during intercourse of 34% (95% confidence interval 27-40%) and 45% (95% confidence interval 38-52%) for orgasm during masturbation. These results show that the wide variation in orgasmic dysfunction in females has a genetic basis and cannot be attributed solely to cultural influences. These results should stimulate further research into the biological and perhaps evolutionary processes governing female sexual function.
Article
Many studies report discordance between women's genital (vaginal pulse amplitude) and subjective sexual arousal responses to erotica. Consistent with our previous research, I hypothesized that the association between physiological and subjective domains would be greater for women with greater orgasmic consistency (OC) during penile-vaginal intercourse but not for OC during masturbation or noncoital partnered sexual activities. I confirmed this specific hypothesis in a sample of young Dutch women (N = 27, mean age 20, all with current partners), replicating our earlier psychophysiological findings with postmenopausal women. Also replicated were the findings that intercourse OC (40% of the women had an orgasm from 90-100% of intercourse events, 44% from 9-89% of intercourse events) was not less than for other sexual activity and that OC during intercourse was uncorrelated with OC during masturbation. We observed the association of intercourse consistency with genital-subjective concordance when visual erotica was presented in a sequence of increasing intensity (analogous to typical real sexual encounters) but not when presented in decreasing, random, or fixed-intensity sequence. I discuss the results in terms of the unique nature of penile-vaginal intercourse and the study's implications for sex therapy and sex research.
Article
As panic disorder (PD) has a chronic course, it is important to identify predictors that might be related to non-remission. The aim of this study is to verify whether history of trauma and defense style are predictors to pharmacological treatment response in PD patients. The sample was composed by 47 PD patients according to DSM-IV who were treated with sertraline for 16 weeks. Evaluations were assessed by the C.G.I. (Clinical Global Impression), the Hamilton-Anxiety Scale, the Hamilton-Depression Scale, the Panic Inventory and the DSQ-40 (Defense Style Questionnaire) at baseline and after treatment. Full remission was observed in 61.7% of the sample. The predictors significantly associated with non-remission were: severity of PD (p=0.012), age of onset (p=0.02) and immature defenses (p=0.032). In addition, the history of trauma was associated with early onset of PD (p=0.043). Panic patients had as predictors of worse response to pharmacological treatment the early onset and the severity of PD symptoms as well as the use of immature defenses at baseline. This finding corroborates the relevance of the evaluation of factors that might affect the response so as to enable the development of appropriate treatment for each patient.
Article
A growing empirical literature demonstrates that the only sexual behavior consistently associated with indices of better physiological and psychological function is the one sexual behavior relevant to potential gene propagation. In the present study, 30 Portuguese women reported on their frequency of different sexual behaviors and corresponding orgasm rates and also completed the Perceived Relationship Quality Components (PRQC) Inventory. As hypothesized, frequency of penile-vaginal intercourse correlated positively with PRQC dimensions: Satisfaction, Intimacy, Trust, Passion, Love (all r >/= .40) and Global Relationship Quality (r = .55). Noncoital sexual behaviors with a partner were uncorrelated with the PRQC dimensions. Masturbation frequency was inversely associated with Love (r = -.38). Penile-vaginal orgasmic frequency correlated positively with PRQC dimensions: Satisfaction, Intimacy, Passion, Love (all r >/= .44) and Global Relationship Quality (r = .52). Penile-vaginal intercourse orgasmic consistency was inversely associated with masturbation frequency. Social desirability scores did not confound the associations. Results are discussed in terms of both evolutionary and psychoanalytic theories.
Article
Female genital mutilation/cutting (FGM/C) violates human rights. FGM/C women's sexuality is not well known and often it is neglected by gynecologists, urologists, and sexologists. In mutilated/cut women, some fundamental structures for orgasm have not been excised. The aim of this report is to describe and analyze the results of four investigations on sexual functioning in different groups of cut women. Instruments: semistructured interviews and the Female Sexual Function Index (FSFI). Sample: 137 adult women affected by different types of FGM/C; 58 young FGM/C ladies living in the West; 57 infibulated women; 15 infibulated women after the operation of defibulation. The group of 137 women, affected by different types of FGM/C, reported orgasm in almost 86%, always 69.23%; 58 mutilated young women reported orgasm in 91.43%, always 8.57%; after defibulation 14 out of 15 infibulated women reported orgasm; the group of 57 infibulated women investigated with the FSFI questionnaire showed significant differences between group of study and an equivalent group of control in desire, arousal, orgasm, and satisfaction with mean scores higher in the group of mutilated women. No significant differences were observed between the two groups in lubrication and pain. Embryology, anatomy, and physiology of female erectile organs are neglected in specialist textbooks. In infibulated women, some erectile structures fundamental for orgasm have not been excised. Cultural influence can change the perception of pleasure, as well as social acceptance. Every woman has the right to have sexual health and to feel sexual pleasure for full psychophysical well-being of the person. In accordance with other research, the present study reports that FGM/C women can also have the possibility of reaching an orgasm. Therefore, FGM/C women with sexual dysfunctions can and must be cured; they have the right to have an appropriate sexual therapy.
New introductory lectures on psychoanalysis
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Die Funktion des Orgasmus [The function of the orgasm]. Vienna: International Psychoanalytischer Verlag
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Reich W. Die Funktion des Orgasmus [The function of the orgasm]. Vienna: International Psychoanalytischer Verlag; 1927.