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Background A number of studies have found that hypersexuality is associated with a high propensity for sexual excitation. In comparison, less is known about the relationship between hypersexuality and sexual arousal at the state level. Also, previous research has revealed a relationship between hypersexuality and negative mood. However, the possibility that sexual response might not be as negatively impacted by negative mood in hypersexual individuals has, as yet, not been tested. Aim The purpose of this study was to investigate sexual responsivity and the effects of negative mood on sexual arousal in hypersexual men who have sex with men (MSM). Methods A total of 211 MSM were assigned to a hypersexuality (N = 81) or a control (N = 130) group using an interview patterned with a semi-structured Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders format. Participants filled out questionnaires and were shown neutral, sexual, and anxiety- and sadness-inducing films. Outcomes Changes in penile circumference and self-reported sexual arousal were the primary outcomes analyzed in this study. Results Controlling for age and HIV status, no differences were found in genital response between hypersexual and non-hypersexual men. Also, the 2 groups did not differ in subjective sexual arousal. Moreover, no effects of negative mood were found. Time series clustering analyses revealed 3 groups—low responders and slow and fast high responders. Sexual excitation, but not sexual compulsivity or pornography use, predicted cluster membership. Clinical Translation Hypersexual MSM may benefit more from an exploration of motivational and behavioral, as compared to psychophysiological, mechanisms underlying possible links between (negative) mood and sexual behavior. Strengths & Limitations Strengths of the study include its sample size, making it one of the larger psychophysiological sex studies; the use of clinical interviews for group assignment; the inclusion of genital response measures; and the application of time series clustering to examine differences among participants. Limitations include possible sample heterogeneity and the reliance on researcher-selected stimuli. Conclusion Given the lack of any effects of negative mood on sexual response in hypersexual MSM, future studies could explore in more depth possible motivational and behavioral effects, including, for example, the impact of negative mood on the tendency to seek out sex as a form of distraction or for validation or emotional support.

Extant literature supports a relationship between sexual arousal and increased likelihood of sexually coercive behavior in men. The present study investigated the impact of sexual arousal on sexual coercion proclivity and the degree to which emotion regulation moderated this relationship in the context of two separate affect inductions. We predicted that sexual arousal would more strongly predict sexual coercion likelihood for men scoring lower on emotion regulation ability compared with men with above average emotion regulation abilities. Male participants with (n = 38) and without (n = 40) self-reported histories of sexual coercion were recruited from urban sexually transmitted infection testing clinics. Participants completed a measure of emotion regulation, underwent a positive and negative affect induction, viewed an erotic video, and reported on their level of sexual arousal immediately prior to completing a hypothetical sexual coercion likelihood laboratory task. Relationships between emotion regulation, sexual arousal, and sexual coercion likelihood were examined using moderation analyses. Sexual arousal was associated with greater reported sexual coercion likelihood. For men with poorer emotion regulation, sexual arousal significantly and positively predicted sexual coercion likelihood in the positive affect condition. Sexual arousal did not significantly predict sexual coercion for men with above average emotion regulation. Findings may have implications for the assessment of individual risk for coercive sexual behavior as well as primary prevention efforts. ispartof: JOURNAL OF INTERPERSONAL VIOLENCE vol:37 issue:1-2 pages:NP264-NP280 ispartof: location:United States status: published

To investigate sexual excitation (SE) and sexual inhibition (SI) profiles in men with erectile dysfunction (ED) and to examine how these dimensions discriminate between men with and without ED.A clinical sample of 37 men with situational (psychogenic) ED and a control group of 40 sexually healthy men (matching the clinical group in age, marital status, and educational level) were constituted. Participants completed self-reported questionnaires assessing sexual function and the propensity for SI and SE.Higher propensities for SI due to the threat of performance failure (SIS1, P.001) and SI due to the threat of performance consequences (SIS2, P.01) were found in the group of men with ED. No significant differences were found between the 2 groups in the propensity for SE.Findings offer additional support for the Dual Control Model of Sexual Response and underscore the relevance of inhibitory mechanisms as potential psychobiological risk factors for the development and maintenance of ED. Findings also highlight the importance of a multidisciplinary approach in the clinical management of ED.

The quality of communication between romantic partners has consistently been found to be associated with relationship well-being and stability. Studies on sexual and nonsexual communication, however, have typically assessed communication skills and behaviors using self-report measures. The use of observational methods has several advantages, including the ability to capture and allow for the independent coding of both partners' communication behaviors. With few exceptions, research applying observational methods has not distinguished between sexual and nonsexual communication behaviors. In the present study, we asked 126 young, mixed-sex couples to engage in sexual and nonsexual conflict discussions. The two 7-min discussions were videotaped and rated by trained coders on nine behavioral dimensions using an adaptation of the specific affect coding system (GottmanKrokoff, 1989) and the system for coding interactions and family functioning (LindahlMalik, 2001). Coder ratings applied to the discussion as a whole. Analyses included factor analysis on the behavioral dimensions and multilevel modeling incorporating the actor-partner interdependence model (APIM). We found significant differences in how couples interacted during the two discussions, with more positive (affectionate and validating) and less negative behaviors during sexual discussions as compared to nonsexual discussions. In both women and men, expressions of positivity during the two types of conflict discussions were associated with higher relationship satisfaction. Gender differences were found in the association between negative behaviors during sexual discussions and relationship satisfaction, with men but not women's negative behaviors being associated with lower relationship satisfaction. These findings point at distinct qualities of sexual communication and its association with couples' relational well-being and contribute to a better scientific understanding, with clinical relevance, of sexual and nonsexual communication.

While the interactive nature of sexual desire in women is increasingly recognized, dyadic factors affecting it, including partner interactions, have as yet received little research attention. In this cross-sectional study, we examined the associations among intimacy, celebrated otherness, and object-of-desire affirmation and explored how they complement each other in the prediction of sexual desire in women. Based on the reports of 662 participants, positive correlations were found among all factors. However, in a multiple regression analysis, object-of-desire affirmation emerged as the only positive predictor of sexual desire. ispartof: JOURNAL OF SEX & MARITAL THERAPY vol:45 issue:5 pages:414-423 ispartof: location:England status: published

Infrared thermography (IRT) is a non-contact technique that permits mapping and analysis of the temperature of the body's skin surface. This method has been applied to sexual psychophysiology since the 1980s and its use has been expanding ever since, mainly because it provides several advantages over existing genital response measures. This article presents a review of experimental studies employing IRT to investigate human sexual arousal, with the aim of summarizing the available procedures and evidence so far and to identify important caveats in the literature. The studies reviewed support the feasibility and validity of IRT as a real-time physiological measure of sexual arousal but varied substantially regarding methodology and procedures. The results of this review underscore the value and validity of IRT in sexual psychophysiology and point at the critical need for the standardization of IRT protocols to accommodate the specific needs of applying this methodology to sexual physiology.

The Sexual Inhibition and Sexual Excitation Scales (SIS/SES) were developed to assess individual propensities for sexual excitation and sexual inhibition in men and women. The objective of the present study was to validate the Portuguese version of the SIS/SES and to investigate the degree to which SIS/SES scores predict different dimensions of Portuguese men's and women's sexual functioning. Gender differences were also examined. A community sample of 370 Portuguese men and 373 women completed self-report measures of sexual function (IIEF, Rosen et al., 1997; FSFI, Rosen et al., 2000) and of the propensity for sexual inhibition and sexual excitation (SIS/SES, Janssen et al., 2002a). Exploratory factor analysis revealed a three-factor solution further supported by confirmatory factor analysis. The three factors identified resemble the original ones, and reliability analyses indicated they have both satisfactory internal consistency and stability over time. Age and Sexual Inhibition Due to the Threat of Performance Failure (SIS1) were both significant negative predictors of men's sexual desire, erectile function, and orgasm. Sexual Excitation (SES) was a positive predictor of sexual desire in both men and women and of men's erectile function and of women's lubrication and orgasm. Age was also a significant and negative predictor of women's sexual desire. Significant gender differences were found for all three SIS/SES scales with men having significantly higher excitation and lower inhibition scores as compared to women. The Portuguese version of the SIS/SES was shown to be suitable for use within the Portuguese population in both clinical and basic research. Our findings provide further cross-cultural validation of the Dual Control Model of Sexual Response and underscore the importance of the role of excitatory and inhibitory processes in women's and men's sexual functioning and response.

Previous research has suggested that sexually aggressive behavior and sexual HIV risk behavior are associated. Childhood sexual abuse (CSA) is a well-established risk factor for both types of problematic sexual behavior. Negative affect (i.e., anxiety, depression, and anger) is a less well-studied risk factor, but it has been theorized to relate to both sexual aggression and HIV risk behavior. Thus, this study sought to (1) confirm the relationship between sexual aggression and HIV risk behavior, (2) establish CSA and negative affect as shared risk factors for sexual aggression and HIV risk behavior, and (3) evaluate whether negative affect mediates the relationship between CSA and sexual aggression and between CSA and HIV sexual risk in a sample of heterosexual men. We recruited 18- to 30-year-old heterosexual men (N = 377) from urban sexually transmitted infection clinics. Men completed measures of sexual HIV risk history (number of partners and condom use), sexual aggression history, CSA history, and trait negative affect (anger, anxiety, and depression). Structural equation modeling was used to examine hypothesized direct and indirect relationships. In the final SEM model, sexual aggression history and sexual HIV risk behavior were correlated. CSA was associated with both types of problematic sexual behavior. Anxiety significantly mediated the relationship between CSA and sexual aggression and between CSA and sexual HIV risk behavior (χ 2[1300] = 2121.79, p

Despite increased attention to understanding risk factors for sexual aggression, knowledge regarding the emotional and sexual arousal patterns of sexually aggressive men remains limited. The current study examined whether sexually aggressive men exhibit unique profiles of affective responsivity, in particular to negatively-valenced stimuli, as well as sexual arousal patterns that differentiate them from nonaggressive men. We presented 78 young men (38 sexually aggressive and 40 nonaggressive) with a series of videos designed to induce positive, sad, or anxious affect. Affect and subjective sexual arousal were assessed following each film and erectile responses were measured continuously. Sexually aggressive men reported significantly higher levels of sexual arousal in both the positive and negative conditions as compared to nonaggressive men. Erectile responses of sexually aggressive men were significantly greater than nonaggressive men’s following the positive affect induction. Self-reported positive affect, but not negative affect, was a significant predictor of subjective sexual arousal for both groups of men. Compared to nonaggressive men, sexually aggressive men showed significantly weaker correlations between subjective and physiological sexual arousal. Findings suggest that generalized heightened propensity for sexual arousal may be a risk factor for sexual aggression perpetration. ispartof: Journal of Sex Research vol:54 issue:8 pages:984-993 ispartof: location:United States status: published

Background Although their individual contributions to sexual and relational outcomes are well-established, there has been a lack of research on the importance of sexual frequency and sexual communication to sexual and relationship satisfaction. Aim To examine the contribution of sexual frequency and sexual communication to sexual and relationship satisfaction in the early stages of couple relationships. Methods A sample of 126 young, heterosexual couples (mean age = 23.3 years, SD = 2.4; average relationship duration = 1.9 years, SD = 0.9) filled out questionnaires about sexual frequency, sexual communication, and sexual and relationship satisfaction. Analyses were guided by the actor-partner interdependence model. Outcomes Main outcome variables were sexual satisfaction and relationship satisfaction, measured by the Quality of Sex Inventory and the Couple Satisfaction Index, respectively. Results Analyses revealed a significant actor effect of both sexual communication and sexual frequency for sexual satisfaction. Only sexual communication, not sexual frequency, predicted relationship satisfaction. No significant partner or gender effects were found. Clinical Translation These findings lend support to the notion that couples could benefit from focusing on non-behavioral processes (eg, sexual communication), rather than sexual behavior per se, when pursuing a fulfilling partnership. Strengths & Limitations Strengths of the study include the dyadic nature of the data and analyses, allowing for the evaluation of both individual- and couple-level processes. Also, to our knowledge, this is the first study to specifically examine the importance of sexual frequency and sexual communication to both sexual and relationship satisfaction. Limitations include the reliance on self-report measures and a relatively homogeneous sample. Conclusion Although both sexual frequency and sexual communication were relevant to the prediction of sexual satisfaction, only sexual communication predicted relationship satisfaction in this sample of young, heterosexual couples. Roels R, Janssen E. Sexual and Relationship Satisfaction in Young, Heterosexual Couples: The Role of Sexual Frequency and Sexual Communication. J Sex Med 2020;17:1643–1652.

Background Although the clitoris is more sensitive to stimulation and its innervation more conducive to sensory feedback than the vagina, the field of sexual psychophysiology, which uses psychophysiological methods including genital response measures to study sexual arousal, relies heavily on the measurement of vaginal, rather than clitoral, pulse amplitude. Aim To develop and test a new clitoral photoplethysmograph for the measurement of clitoral pulse amplitude (CPA). Methods 2 versions of the new device, which differed in the orientation of the sensor and light source (parallel vs angled), were tested in 15 premenopausal, sexually functional women. Vaginal pulse amplitude (VPA) was assessed simultaneously. The women viewed a 3-minute erotic and an anxiety-inducing film segment with each clitoral sensor, interspersed with neutral video excerpts. In addition, they were asked to indicate their subjective level of sexual arousal during and after erotic video presentations. Outcomes The main outcome measures are CPA, VPA, and subjective sexual arousal. Results The clitoral photoplethysmograph successfully detected CPA. The quality of the signals was best for the angled sensor. Main effects of the film and the interaction between the film and epoch were stronger for the clitoral than for the vaginal device. In addition, CPA followed more closely changes in intensity of sexual films than VPA. Within- and between-subject correlations between genital response and subjective sexual arousal were higher for the clitoral than for the vaginal device. Clinical Translation Comparison of CPA with other genital blood flow measures in clinical samples is indicated and may contribute to improved physiological assessments of sexual response in women. Strengths and Limitations Our sample was small and consisted of healthy volunteers. Future research could examine test-retest reliability, by including multiple recording sessions, and further explore the specificity of CPA by comparing sexual and non-sexual stimuli with positive valence. Conclusion This study presents the first instrument to successfully measure CPA.

Introduction Hypersexuality has been conceptualized as sexual addiction, compulsivity, and impulsivity, among others, in the absence of strong empirical data in support of any specific conceptualization. Aim To investigate personality factors and behavioral mechanisms that are relevant to hypersexuality in men who have sex with men. Methods A sample of 242 men who have sex with men was recruited from various sites in a moderate-size mid-western city. Participants were assigned to a hypersexuality group or a control group using an interview similar to the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition. Self-report inventories were administered that measured the broad personality constructs of positive emotionality, negative emotionality, and constraint and more narrow constructs related to sexual behavioral control, behavioral activation, behavioral inhibition, sexual excitation, sexual inhibition, impulsivity, attention-deficit/hyperactivity disorder, and sexual behavior. Main Outcome Measures Hierarchical logistic regression was used to determine the relation between these personality and behavioral variables and group membership. Results A hierarchical logistic regression controlling for age showed a significant positive relation between hypersexuality and negative emotionality and a negative relation with constraint. None of the behavioral mechanism variables entered this equation. However, a hierarchical multiple regression analysis predicting sexual behavioral control indicated that lack of such control was positively related to sexual excitation and sexual inhibition owing to the threat of performance failure and negatively related to sexual inhibition owing to the threat of performance consequences and general behavioral inhibition Conclusion Hypersexuality was found to be related to two broad personality factors that are characterized by emotional reactivity, risk taking, and impulsivity. The associated lack of sexual behavior control is influenced by sexual excitatory and inhibitory mechanisms, but not by general behavioral activation and inhibitory mechanisms.

Background Among older men, comparable cross-cultural investigations of sexual problems and associated distress that also include a multitude of relevant explanatory variables of these sexual problem and related distress are rare in the research literature. Aims To investigate prevalence rates of sexual problems and associated distress among older men across 4 European countries (Norway, Denmark, Belgium, and Portugal) and assess for associated mental and physical health–related factors. Methods Multinational cross-sectional questionnaire study using self-report measures. Outcomes Prevalence rates of sexual problems and associated distress levels. Results We found a high prevalence of sexual problems persisting for months or longer across countries, but noted that many affected men experienced minimal or no distress related to these problems. We also found marked cross-cultural differences in reported distress about sexual problems, with southern European men (ie Portugal) reporting significantly more distress related to the majority of sexual problems investigated compared with northern European men (ie Denmark and Norway). Finally, we identified several relational, physical, and mental health problems associated with the reported number of sexual problems and the distress related to these problems. Clinical Implications We suggest that healthcare professionals also target distress when considering sexual problems among older men and contextualize these considerations within a multifactorial approach to general health in which (other) mental and physical health factors relevant to these patients’ sexual health and function are also jointly considered. Strengths & Limitations Strengths of this study include the large sample size, inclusion of participants from 4 European countries, assessment of distress associated with sexual problems, and similar research design and method of data collection across the 4 included countries. Limitations of the study include the cross-sectional design, which precludes causal conclusions; the low response rate in the Portuguese sample; the lack of homosexual participants; and the lack of comprehensive assessments of dyadic factors that may be of relevance to sexual problems and associated distress. Conclusion This study identified a high prevalence of sexual problems persisting for 3 months or longer among older men across 4 European countries, but also found that many of the men with sexual problems experienced minimal or no distress related to these problems.

The aim of this article was to describe partnered and non-partnered sexual activity and sexual satisfaction in older men and women from Norway, Denmark, Belgium, and Portugal, and to explore sociodemographic correlates of sexual activity and satisfaction. Data were collected in 2016 using postal, anonymous questionnaires in probability samples of the population aged 60-75 years recruited by phone registers in Norway (676 men, 594 women), Denmark (530 men, 515 women), Belgium (318 men, 672 women), and Portugal (236 men, 273 women). In men, the percentage of sexually active participants in the past year ranged from 83% in Portugal to 91% in Norway. In women, the percentage of sexually active participants during the last year ranged from 61% in Belgium to 78% in Denmark. Regarding frequency of sexual intercourse activity during the past month, men in Norway, Denmark, and Belgium (23-24%) most often reported 2-3 times per month, whereas most men in Portugal (29%) reported 1-3 times per week. Masturbation was most commonly reported among Norwegian men (65%) and women (40%), and least commonly in Portugal. Concerning sexual satisfaction, across all countries, 40-60% of participants reported that they were sexually satisfied. Portuguese men and Danish women reported being most sexually satisfied. Having a partner was the most important positive predictor of sexual activity and sexual satisfaction in all subgroups except Portuguese men. In conclusion, partnered sexual activity was more frequent in the south of Europe, and solitary sexual activity more frequent in Northern Europe. ispartof: ARCHIVES OF SEXUAL BEHAVIOR vol:48 issue:3 pages:815-829 ispartof: location:United States status: published

Introduction Many sexual difficulties encountered by couples in their day-to-day lives, although of insufficient intensity and persistence to warrant a clinical diagnosis of sexual disorder, are nevertheless frequent and a source of individual and relational distress. Aim The aim of this study was to assess the event-level associations between couples’ everyday, subclinical sexual difficulties (specifically, low subjective sexual arousal, low physiological sexual arousal, and genito-pelvic pain), the range of sexual behaviors that these couples engage in, and their sexual satisfaction. Methods 70 Newlywed participants (35 couples, average age = 25.6 years, SD = 3.2 years; average duration of relationship = 5.4 years, SD = 3.4 years) individually completed daily diaries about sexual difficulties, range of activities performed during sex, and sexual satisfaction over the course of 5 weeks. Analyses were guided by the actor-partner interdependence model. Main Outcome Measure The main outcome was sexual satisfaction, measured at the event-level on a 5-point Likert scale using a single-item question. Results On days of sexual activity, men and women’s difficulties with subjective sexual arousal were associated with lower sexual satisfaction in both partners (actor and partner effects). This association was mediated by the range of couples’ sexual behaviors, such that lower subjective arousal was associated with a more restricted range of sexual activities, which in turn was associated with lower sexual satisfaction. Men’s and women’s difficulties with physiological sexual arousal, and women’s genito-pelvic pain, were each associated with their own lower sexual satisfaction. No partner effects were observed for these sexual difficulties, nor were they mediated by the range of couples’ sexual activities. Clinical Implications The study’s results highlight how couples’ sexual difficulties can interfere with same-day sexual satisfaction, and how for subjective sexual arousal, this interference is reflected by a more restricted range of sexual behaviors. Strength & Limitations Strengths of the study include the daily diary methodology, which allowed a focus on event-level sexual activities with minimal retrospective bias. Further, the dyadic analyses allowed both intra-individual and inter-individual effects to be assessed. Limitations include the lack of a more general measure of sexual desire and of a more diverse sample, in terms of age, race, and sexual orientation. Conclusion These findings underscore the importance of treatments that include both partners, and that target the types as well as range of sexual activities in which couples engage.

Previous research using the Mood and Sexuality Questionnaire (MSQ) has revealed substantial variability in how negative mood impacts sexual response and behavior. However, the MSQ does not address differences between desire for solo or partnered sexual activity, examine the effects of sexual activity on mood, or assess the effects of positive mood. This article presents the development and factor structure of the Revised Mood and Sexuality Questionnaire (MSQ-R). An exploratory factor analysis in a sample of heterosexual men, homosexual men, and heterosexual women (N = 1,983) produced eight factors. Considerable variability was found in how moods influence sexual desire and arousal, in the effects of mood on sexual behavior, and in the reciprocal effects of sexual activity on mood. Among other findings, heterosexual women were less likely than heterosexual men and homosexual men to experience increased sexual desire and arousal when anxious or stressed, whereas homosexual men and heterosexual women were less likely than heterosexual men to experience increased desire when sad or depressed. Heterosexual men and heterosexual women were more likely than homosexual men to report increased desire when in a positive mood. Intercorrelations and correlations with various sexual behaviors varied by group. Limitations and implications of the findings are discussed.

Recent studies show that sexual approach (SA) motives, i.e., having sex to achieve a positive state such as sexual pleasure, are associated with higher sexual and relationship satisfaction. However, mechanisms linking SA motives to these outcomes are poorly understood, and the important distinction between SA motives that are self-directed (e.g., self-gratification) and other-directed (e.g., pleasing one's partner) has received little empirical attention, particularly in the everyday context of couples' sexuality. The present study focused, at an event level, on the associations between self-directed and other-directed SA motives, and sexual satisfaction and perceived partner responsiveness (PPR, an aspect of relationship intimacy). We also examined the mediating role of the couple's sexual behavior in these associations. Data were collected over a month-long daily diary study involving 35 newlywed heterosexual couples and analyzed using the Actor-Partner Interdependence Model. Results showed that men and women's self-directed SA motives were associated with their own higher sexual satisfaction and, in men, with their female partners' sexual satisfaction as well. For both men and women, these associations were mediated by sexual behavior: Self-directed SA motives were associated with more genitally focused sexual behavior (e.g., vaginal intercourse, oral sex), in turn associated with higher sexual satisfaction. For men, other-directed SA motives were associated with their own greater PPR and with that of their female partners. For women, self-directed SA motives were associated with their own greater PPR and with that of their male partners. Sexual behavior did not mediate associations with PPR. Theoretically, these findings support dyadic models of sexual satisfaction and intimacy and indicate that self-directed SA motives may be more important to sexual satisfaction than other-directed motives. Clinically, they support sex therapy approaches that integrate both partners and suggest that sexual motives and behavior may be relevant targets for intervention. ispartof: ARCHIVES OF SEXUAL BEHAVIOR vol:48 issue:3 pages:831-842 ispartof: location:United States status: published

Introduction Although impaired sexual function is relatively common, not all sexual impairments are associated with distress. To date, most studies on protective and risk factors for sexual distress have asked about distress in a more general manner and have failed to distinguish different dimensions of sexual distress. Aim To examine the association of several intra- and interpersonal factors with personal, perceived partner, and interpersonal distress due to an impairment in sexual functioning in women. Methods This study is a cross-sectional representative population-based survey with a two-level random selection of Flemish women 14 to 80 years old from the Belgian National Register. The data of 520 sexually active heterosexual women with a partner (weighted N) and impairment in sexual desire (n = 291) and/or sexual arousal (n = 273) were used for analysis. Main Outcome Measures Demographic information was obtained, and the five-item Mental Health Inventory, the Marital Adjustment subscale of the Maudsley Marital Questionnaire, and the four-item Dyadic Sexual Communication Questionnaire were used. Presence and severity of sexual impairments and associated sexual distress were assessed using the Sexual Functioning Scale. Results Severity and number of sexual impairments were predictive of all types of sexual distress. Also, for desire and arousal impairments, lower mental well-being predicted personal distress, and lower relationship satisfaction predicted perceived partner distress. For desire impairments, lower relationship satisfaction and less communication about sexual needs were predictive of interpersonal distress. For impairments in sexual arousal, lower mental well-being and lower relationship satisfaction were predictive of interpersonal distress. Conclusion Personal, perceived partner, and interpersonal distress due to sexual impairments have different types of predictors. Clinical assessment and treatment could benefit from differentiating between different types of distress and the intra- and interpersonal factors that are associated with them.

Introduction Despite the importance of sexuality for romantic relationships, there has been little research attention to individual differences and dyadic variables, including couple similarity, and their association with sexual problems and satisfaction. Aim The current study examined the effects of the propensity for sexual inhibition and sexual excitation scales (SIS/SES) and the effects of different mood states on sexuality (Mood and Sexuality Questionnaire [MSQ]), at both the individual and the dyad level, on sexual arousal problems and sexual satisfaction. Methods Similarity in SIS/SES and MSQ was measured in a nonclinical sample of 35 newlywed couples and operationally defined as the within‐couple, z‐transformed correlations between the two partners' item responses. Main Outcome Measures Sexual arousal problems were assessed using self‐report measures (Demographic and Sexual History Questionnaire) and focused on the past 3 months. Sexual satisfaction was assessed using the Global Measure of Sexual Satisfaction. Results Regression analyses revealed that greater similarity in the effects of anxiety and stress on sexuality was associated with more reported sexual arousal problems of wives. In contrast, the husbands' sexual arousal problems were related only to their own higher SIS1 scores. Higher SES scores predicted lower sexual satisfaction for both husbands and wives. Wives who reported strong positive mood effects on their sexuality indicated greater sexual satisfaction, while husbands who were more similar to their wives in the effect of positive moods on sexuality indicated greater sexual satisfaction. Conclusions The findings show that, above and beyond one's own sexual propensities, similarity in various aspects of sexuality predicts sexual problems (more so in women) and sexual satisfaction (in both men and women). Lykins AD, Janssen E, Newhouse S, Heiman JR, and Rafaeli E. The effects of similarity in sexual excitation, inhibition, and mood on sexual arousal problems and sexual satisfaction in newlywed couples. J Sex Med 2012;9:1360–1366.

Risky sexual behaviors, including the decision to have unprotected sex, result from interactions between individuals and their environment. The current study explored the use of Agent-Based Modeling (ABM)-a methodological approach in which computer-generated artificial societies simulate human sexual networks-to assess the influence of heterogeneity of sexual motivation on the risk of contracting HIV. The models successfully simulated some characteristics of human sexual systems, such as the relationship between individual differences in sexual motivation (sexual excitation and inhibition) and sexual risk, but failed to reproduce the scale-free distribution of number of partners observed in the real world. ABM has the potential to inform intervention strategies that target the interaction between an individual and his or her social environment.

Bailey, Rieger, and Rosenthal (2011) go at great lengths to try and convince readers that our study (Cerny & Janssen, 2011) failed to demonstrate what it set out to do. However, our study did not set out to do what they claim it set out to do. In fact, Bailey et al. misrepresent the goals, analyses, and conclusions of our study. The goal of our study was not to demonstrate that bisexual men respond with substantial genital arousal to both maleandfemalestimuli. Thepurposeofourstudywas todetermine if men with different sexual orientations show differential genital and subjective arousal patterns to video presentations of bisexual, heterosexual, and homosexual sexual interactions. The genital response analyses did not consist of‘‘two main analyses’’but of one single mixed-model analysis. And our conclusions were not about something Bailey et al. like to refer to as‘‘bisexual arousal.’’Instead, we concluded that bisexuality in men was associated with a unique and specific pattern of sexual arousal. This was based on the finding that the bisexual and other men responded similarly to some and differently to other stimuli—most critically, the bisexual men responded with greater penile tumescence to a video depicting a man engaged in sex with both a man and a woman than both the homosexual or heterosexual men. The Long of It

This study aimed to assess the relative importance of demographic, interpersonal, and personality factors in predicting sexual infidelity in heterosexual couples. A total of 506 men (M age = 32.86 years, SD = 10.60) and 412 women (M age = 27.66 years, SD = 8.93), who indicated they were in a monogamous sexual relationship, completed a series of questionnaires, including the Sexual Excitation/Inhibition (SES/SIS) scales and the Mood and Sexuality Questionnaire, and answered questions about, among others, religiosity, education, income, relationship and sexual satisfaction, and sexual compatibility. Almost one-quarter of men (23.2%) and 19.2% of women indicated that they had "cheated" during their current relationship (i.e., engaged in sexual interactions with someone other than their partner that could jeopardize, or hurt, their relationship). Among men, a logistic regression analysis, explaining 17% of the variance, revealed that a higher propensity of sexual excitation (SES) and sexual inhibition due to "the threat of performance concerns" (SIS1), a lower propensity for sexual inhibition due to "the threat of performance consequences" (SIS2), and an increased tendency to engage in regretful sexual behavior during negative affective states were all significant predictors of infidelity. In women, a similar regression analysis explained 21% of the variance in engaging in infidelity. In addition to SIS1 and SIS2, for which the same patterns were found as for men, low relationship happiness and low compatibility in terms of sexual attitudes and values were predictive of infidelity. The findings of this study suggest that, for both men and women, sexual personality characteristics and, for women, relationship factors are more relevant to the prediction of sexual infidelity than demographic variables such as marital status and religiosity.

The way couples communicate during conflict discussions has been found to be a reliable predictor of marital satisfaction. However, in previous research, there has been little experimental control over the selection of topics. The present study examined, in a sample of 15 newlywed couples, whether affective displays during the discussion of a sexual and a nonsexual conflict topic differentially predict current marital satisfaction. Communication behaviors were coded using an adaptation of the Specific Affect Coding System, resulting in composite "negative behavior" and "positive behavior" categories. Data were analyzed using multilevel modeling. Negative behaviors displayed during the nonsexual conflict discussions were not significantly related to concurrent self-reported relationship satisfaction. In contrast, for wives, negative behaviors displayed during the discussion of a sexual problem were significantly related to lower levels of relationship satisfaction. For the sexual and nonsexual conflict discussions, positive behaviors were positively associated with relationship satisfaction, although this effect did not reach statistical significance. Overall, the authors' findings emphasize the importance of incorporating sexual variables in the study of marriage. Furthermore, their study represents an important step in recognizing that marital research benefits from an examination of specific topics of conflict as a factor to consider in studies of marital functioning.

Past research has demonstrated that women do not show a “category-specific” genital response to erotic stimuli. That is, on average, heterosexual and lesbian women are indistinguishable in terms of their physiological genital responses to heterosexual versus lesbian erotica. In two studies with heterosexual women (n = 28 for Study 1; n = 30 for Study 2) and lesbians (n = 24 for Study 1; n = 25 for Study 2), results confirmed that, on average, women did not show category-specific genital responses or category-specific subjective sexual arousal. However, there was evidence of notable within-group variability; many women did respond to the stimuli in a category-specific manner. Heterosexual women were more likely than lesbian women to demonstrate category-specificity. Findings also revealed that category-specificity was associated with multiple factors, including affective responses to the erotic stimuli and sexual history. Results of this study highlight the complexity of women’s sexual identities and sexual responses.

Women’s sexual interest changes with hormonal fluctuations across the menstrual cycle. It is unclear how hormones modify women’s sexual behavior and desire, but one possibility is that they alter women’s positive appraisals of stimuli and thus their sexual interest. Using 3 T fMRI, we measured neural activation in women at two time points in their menstrual cycle (late follicular, luteal) while they evaluated photos of men presented as potential sexual partners. Participants were ten heterosexual women aged 23–28 none of who was using hormonal contraceptives or in a committed relationship. In an event-related design, the women were presented with as series of photos of male faces and asked questions to assess their degree of sexual interest in the men depicted. Results demonstrate an overall effect of menstrual cycle phase on neural activation. During their follicular versus luteal phase, women demonstrated increased activation in the right medial orbitofrontal cortex (OFC), suggesting increased positive appraisal. Activation in the OFC was positively correlated with women’s estradiol to progesterone ratios. There were no areas that demonstrated increased activation during the luteal versus follicular phase. The observed increase in activation in the OFC during the follicular phase may reflect a hormonally mediated increase in appetitive motivation and may prime women towards increased sexual interest and behavior around ovulation.

The Dual Control Model proposes that sexual responses involve an interaction between sexual excitatory and sexual inhibitory processes. The model further postulates that individuals vary in their propensity for both sexual excitation and sexual inhibition, and that such variations help us to understand much of the variability in human sexuality. The development of psychometrically validated instruments for measuring such propensities for men (Sexual Inhibition/Sexual Excitation Scales) and for women (Sexual Excitation/Sexual Inhibition Inventory for Women) is described. These measures show close to normal variability in both men and women, supporting the concept that "normal" levels of inhibition proneness are adaptive. The relevance of the model to sexual development, sexual desire, the effects of aging, sexual identity, and the relation between mood and sexuality are discussed, and the available evidence is reviewed. Particular attention is paid to gender differences and similarities in propensities for sexual excitation and inhibition. Research findings related to sexual problems, high-risk sexual behavior, and the relevance of this model to clinical management of such problems are also summarized. Last, ideas for future use and further development of the Dual Control Model are considered.

The Sexual Inhibition/Sexual Excitation Scales (SIS/SES) assess individual propensitiesto become sexually aroused and to inhibit arousal. Prior analyses of men’s SIS/SES data(Janssen, Vorst, Finn, & Bancroft, 2002a) yielded one excitation factor (SES) and twoinhibitory factors (SIS1/Threat of Performance Failure and SIS2/Threat of PerformanceConsequences). The current study utilized a dataset of 2,045 undergraduates (1,067 women and 978 men) to examine the psychometric properties of women’s SIS/SESscores.Women scored higher on sexual inhibition and lower on sexual excitation compared withmen. The convergent/discriminant validity of women’s SIS/SES scores globally resembledmen’s, but showed stronger associations with other sexualityrelated measures and lesspronounced relationships with measures of general behavioral approach/avoidance. Thetest-retest reliability of men’s and women’s SIS/SES scores were similar, but individual items exhibited differential relevance to men’s and women’s arousal. An exploratory factor analysis of women’s scores was utilized to further examine shared and unshared themes.

Little is known about why individuals vary in their levels of sexual desire. Information processing models, like Barlow's (Journal of Consulting and Clinical Psychology 54:140-148, 1986) model of sexual functioning, suggest that individuals with higher sexual desire attend more and respond with more pleasant emotions to sexual cues than individuals with lower levels of sexual desire. In this study, 69 participants (36 women, 33 men) completed a dot detection task measuring attention capture by sexual stimuli and a startle eyeblink modulation task indexing the valence of emotional response to affective stimuli. Participants with high levels of sexual desire were slower to detect targets in the dot detection task that replaced sexual images but did not differ in startle eyeblink responses to sexual stimuli. The results suggest that the amount of attention captured by sexual stimuli is a stronger predictor of a person's sexual desire level than the valence of the emotional responses elicited by such stimuli.

Introduction Condom-associated erection problems (CAEP) are an underestimated factor related to inconsistent or incomplete male condom use. The underlying mechanisms of CAEP are not understood, and whether men who report these difficulties are also likely to experience erectile problems in situations when condoms are not used has not been studied. Aim The aim of the study was to investigate, in a sample of condom-using young, heterosexual men (aged 18–24 years), whether men who report CAEP are more likely to (i) have erection problems when not using condoms and (ii) meet criteria for erectile dysfunction. Methods A total of 479 men recruited online completed the International Index of Erectile Function (IIEF-5) and answered questions about erection problems experienced when using and not using condoms during the last 90 days. Demographic, sexual experience, and health status variables were investigated as correlates. Main Outcome Measures Self-reported frequency of erection loss during condom application or during penile–vaginal intercourse (PVI) in the past 90 days and IIEF-5 scores. Results Of the men, 38.4% were classified in the no CAEP group, 13.8% as having CAEP during condom application, 15.7% as having CAEP during PVI, and 32.2% as having CAEP during both condom application and PVI. Men reporting any form of CAEP were significantly more likely than men reporting no CAEP to also report erection difficulties during sexual activity when not using condoms. Men who reported CAEP during PVI only or during both application and PVI scored significantly lower on the IIEF-5 than men without CAEP. Conclusion The findings suggest that men who report CAEP are also more likely to experience more generalized erection difficulties. Clinicians should assess whether men using condoms experience CAEP and where appropriate, refer for psychosexual therapy or provide condom skills education.

Reduction of unprotected anal intercourse (UAI) in gay men infected with HIV is important in preventing further spread of this infection. In previous studies, personality trait measures relevant to sexual arousability and the effects of anxiety have been shown to relate to UAI in both gay and heterosexual men. Are HIV+ gay men similar in these respects or are there other personality-related factors that influence their sexual risk taking? This question was addressed using a convenience sample of 156 HIV+ gay men and 155 HIV- gay men, matched for age and UAI risk. There were no significant differences between these two groups on measures of sexual arousability, inhibition of sexual arousal in risky situations, sensation seeking, depression and anxiety proneness, or tendency to increased sexual interest in negative mood states. HIV+ men were, however, more likely to report erectile problems and higher scores on an associated trait measure, inhibition of arousal due to threat of performance failure. As this association was not anticipated, questions about whether erectile problems preceded the seroconversion were not asked. Such problems could be associated with reluctance to use condoms, thus increasing the likelihood of seroconversion and/or disease transmission. Alternatively, erectile problems could be a consequence of HIV infection. In each case, this has implications for prevention. The associations among HIV status, erectile problems, and UAI need to be specifically addressed in future research.

The aim of this study was to explore gender differences in sexual responsiveness to erotic films that had been selected for their differential appeal for men and women. A secondary objective was to identify variables that influence sexual arousal and explore whether these variables differ for men and women. Fifteen men (M age = 26 yrs) and 17 women (M age = 24 yrs) were presented with 20 film clips depicting heterosexual interactions, half of which were female- and the other half male-selected, and were asked to rate the clips on a number of dimensions. Overall, men found the film clips more sexually arousing than did the women. Gender differences in arousal were negligible for female-selected clips but substantial for male-selected clips. Furthermore, men and women experienced higher levels of sexual arousal to clips selected for individuals of their own gender. Cluster regression analyses, explaining 77% of the variance for male and 65% for female participants, revealed that men's sexual arousal was dependent upon the attractiveness of the female actor, feeling interested, and both "imagining oneself as a participant" and "watching as an observer." For women, with all variables entered, only "imagining oneself as a participant" contributed to sexual arousal ratings. The findings suggest that how films are selected in sex research is an important variable in predicting levels of sexual arousal reported by men and women.

Introduction Both emotions and cognitions seem to play a role in determining sexual arousal. However, no studies to date have tested the effects of self‐reported thoughts on subjective sexual arousal and genital response using psychophysiological methods. Aim The aim of the present study was to evaluate the role of self‐reported thoughts and affect during exposure to erotic material in predicting subjective and genital responses in sexually healthy men. Methods Twenty‐seven men were presented with two explicit films, and genital responses, subjective sexual arousal, self‐reported thoughts, and positive and negative affect were assessed. Main Outcome Measures Men's genital responses, subjective sexual arousal, affective responses, and self‐reported thoughts during exposure to sexual stimulus were measured. Results Regression analyses revealed that genital responses were predicted by self‐reported thoughts (explaining 20% of the variance) but not by affect during exposure to erotic films. On the other hand, subjective sexual arousal was significantly predicted by both positive and negative affect (explaining 18% of the variance) and self‐reported thoughts (explaining 37% of the variance). Follow‐up analyses using the single predictors showed that “sexual arousal thoughts” were the only significant predictor of subjective response (β = 0.64; P P Conclusions The findings of this study suggest that both affect and sexual arousal thoughts play an important role in men's subjective sexual response, whereas genital response seems to be better predicted by distracting thoughts. Oliveira C, Laja P, Carvalho J, Quinta Gomes A, Vilarinho S, Janssen S, and Nobre PJ. Predictors of men's sexual response to erotic film stimuli: The role of affect and self‐reported thoughts. J Sex Med 2014;11:2701–2708.

A theoretical model of dual control of male sexual response is considered, based on the balancing of central excitation and inhibition, with individuals varying in their propensity for both sexual excitation and inhibition of sexual response. A questionnaire method for measuring propensities for sexual excitation and inhibition has been developed (SIS/SES questionnaire), resulting in one excitation factor (SES) and two inhibition factors (SIS1 and SIS2). Evidence for the existence of both inhibitory and excitatory tone is discussed. The first inhibition factor (SIS1) may be related to level of inhibitory tone and is associated with fear of performance failure. The second inhibition factor (SIS2) may be related to external threats (e.g. from within the sexual relationship). The implications for the treatment of centrally mediated erectile dysfunction are discussed, with predictions that high SIS2 individuals will respond to psychological treatment, whereas high SIS1 individuals will respond better to pharmacological methods of treatment.

Affective and cognitive factors play an important role in the activation and regulation of men's sexual arousal. Barlow (1986) argued that initial affective reactions determine the allocation of attention to sexual stimuli. We applied Barlow's model to our understanding of the role of sexual arousal in sexual orientation, where sexual arousal patterns have consistently been found to be congruent with self-reported orientation in men, but not in women. Visual attention of 28 heterosexual and 22 homosexual men to same- and opposite-sex erotic stimuli was assessed and experimentally-directed by means of a newly developed software application, while genital (penile rigidity) and affective responses (self-reported and physiological) were measured. In line with previous research, we found "category specificity" in men's sexual arousal, in that sexual responses were strongest to orientation-congruent stimuli. Also, both homosexual and heterosexual men experienced stronger sexual responses to conditions in which their attention was directed to sexual versus nonsexual content of orientation-congruent stimuli. Only homosexual men manifested higher sexual responses when their visual attention was directed towards the sexual content of orientation-incongruent stimuli. Heterosexual men experienced weaker positive and stronger negative affective responses to orientation-incongruent content, suggestive of potential avoidance or inhibitory mechanisms. Accepted version

Introduction The specific cognitive–affective mechanisms involved in the activation and regulation of the subjective and genital components of sexual arousal are not fully understood yet. Aim The aim of the present study was to investigate the contribution of self-reported thoughts and affect to the prediction of women's subjective and genital responses to erotica. Methods Twenty-eight sexually functional women (mean age = 32, SD = 6.29) were presented with sexually explicit and nonexplicit romantic films. Genital responses, subjective sexual arousal, state affect, and self-reported thoughts were assessed. Main Outcome Measures Vaginal pulse amplitude was measured using a vaginal photoplethysmograph. Subjective sexual arousal, thoughts, and affective responses were assessed through self-report scales. Results Correlations between subjective and physiological sexual arousal were low ( r = −0.05, P > 0.05). Self-reported thoughts and affect were significant predictors of subjective sexual arousal. The strongest single predictor of subjective arousal was sexual arousal thoughts (e.g., “I'm getting excited”) (β = 0.63, P Conclusions Overall, results support the role of cognitive (self-reported thoughts) and affective dimensions in women's subjective sexual arousal to erotica and, consistent with previous findings, suggest that subjective and physiological sexual arousal may be impacted by different processes. Vilarinho S, Laja P, Carvalho J, Quinta-Gomes AL, Oliveira C, Janssen E, and Nobre PJ. Affective and cognitive determinants of women's sexual response to erotica. J Sex Med 2014;11:2671–2678.

failure but largely to loss of sexual interest, subjectively ascribed to fatigue. The latter was also found in women Background. Sexual dysfunctions are common among patients with chronic renal failure. The prevalence was on haemodialysis or peritoneal dialysis. assessed in a population of 281 patients (20‐60 years), Key words: chronic renal failure; prevalence; biochemand it was attempted to determine whether their mode ical variables; psychophysiology; sexual dysfunctions of treatment (haemodialysis, peritoneal dialysis, or kidney transplantation), or biochemical and endocrine variables and neuropathy aVect sexual functioning. Patients with rheumatoid arthritis served as a compar- Introduction ison group. Methods. Assessment included clinical history, phys- Sexual dysfunctions are common in patients with ical and laboratory examinations, questionnaires chronic renal failure (CRF ). Prevalence estimates run measuring erotosexual dysfunctions, and a psycho- from 9% before starting dialysis to 60‐70% in dialysing physiological test procedure. The latter is a laboratory male and female patients [1,2]. Several somatic factors method which measures, in a waking state, subjective have been implicated in the aetiology of sexual dysfuncand physiological sexual arousal. tions in patients with CRF (for a review see Results. Men on haemodialysis or peritoneal dialysis Handelsman [3]). However, most of these factors lack suVered significantly more often from ‘Hypoactive empirical support. Severe malnutrition, and vitamin Sexual Desire Disorder’, ‘Sexual Aversion Disorder’ and zinc deficiencies were problems in the early days and ‘Inhibited Male Orgasm’ than men with kidney of dialysis, but are relatively rare now. Uraemic toxins transplantation or rheumatoid arthritis. Interestingly, and ‘middle molecules’ have not been convincingly the prevalence of ‘Male Erectile Disorder’ did not implicated. CRF is associated with disturbances of diVer significantly between the four groups and ranged reproductive hormones and prolactin, but their pharmbetween 17 and 43%. Of the women, transplanted acotherapeutic correction has not been proved benefipatients suVered significantly less from ‘Hypoactive cial. Atherosclerosis is accelerated in patients with Sexual Desire Disorder’ than the other three groups; CRF, but the rapid onset of improvement of sexual the prevalence of other sexual dysfunctions did not function following renal transplantation renders it diVer between the groups. Although ‘Male Erectile unlikely that this is an important factor. This also Disorder’ and ‘Female Sexual Arousal Disorder’ had applies to uraemic neuropathy, the progression of a relatively high prevalence there were no diVerences which is being slowed by adequate dialysis. Several in the four groups of patients in genital responses drugs used in the treatment of patients with CRF may during psychophysiological testing. Genital responses interfere with sexual functioning, but their replacement during psychophysiological assessment had no rela- with more modern drugs has not reduced sexual tionship to the duration of renal replacement treat- dysfunction. ment, biochemical/endocrine variables, or the presence/ None of the somatic mechanisms mentioned above absence of neuropathy. has satisfactorily explained the high incidence of sexual Conclusion. The prevalence of sexual dysfunction was dysfunctions in patients with CRF. Thus, psychological high. Sexual dysfunction in men on haemodialysis or mechanisms have to be taken into consideration. In peritoneal dialysis was not so much due to erectile view of the psychosomatic nature of human sexuality, these psychological studies have gained in importance

Investigating the ways in which barrier methods such as condoms may affect penile sensory thresholds has potential relevance to the development of interventions in men who experience negative effects of condoms on sexual response and sensation. A quantitative, psychophysiological investigation examining the degree to which sensations are altered by condoms has, to date, not been conducted.The objective of this study was to examine penile vibrotactile sensitivity thresholds in both flaccid and erect penises with and without a condom while comparing men who do and those who do not report condom-associated erection problems (CAEP).Penile vibrotactile sensitivity thresholds were assessed among a total of 141 young, heterosexual men using biothesiometry. An incremental two-step staircase method was used and repeated three times for each of four conditions. Intra-class correlation coefficients (ICCs) were calculated for all vibratory assessments. Penile vibratory thresholds were compared using a mixed-model analysis of variance.Penile vibrotactile sensitivity thresholds with and without a condom, erectile function measured by International Index of Erectile Function Questionnaire, and self-reported degree of erection.Significant main effects of condoms (yes/no) and erection (yes/no) were found. No main or interaction effects of CAEP were found. Condoms were associated with higher penile vibrotactile sensitivity thresholds (F[1,124] = 17.11, P 0.001). Penile vibrotactile thresholds were higher with an erect penis than with a flaccid penis (F[1,124] = 4.21, P = 0.042).The current study demonstrates the feasibility of measuring penile vibratory thresholds with and without a condom in both erect and flaccid experimental conditions. As might be expected, condoms increased penile vibrotactile sensitivity thresholds. Interestingly, erections were associated with the highest thresholds. Thus, this study was the first to document that erect penises are less sensitive to vibrotactile stimulation than flaccid penises.

Sexuality is an integral part of intimate relationships, yet surprisingly little is known about how and for whom sexuality matters. The present research investigated the interplay of sexual and non-sexual factors that contribute to relationship satisfaction. Specifically, we tested the hypothesis that the association between sexual satisfaction and marital satisfaction is mediated by a non-sexual factor—namely, perceived partner responsiveness (PPR). Additionally, we tested the role of gender as a possible moderator of this mediated association. Thirty-four newlywed couples completed diaries with each spouse reporting their sexual satisfaction, marital satisfaction, and PPR every day for 30 days. We tested our predictions at both the person level (i.e., the mean level across 30 days) and the daily level. At the person level, we found that sexual satisfaction and PPR separately predicted marital satisfaction. Moreover, the effect of sexual satisfaction on marital satisfaction was partially mediated by PPR. No gender differences emerged at this level. At the daily level, we found similar support for partial mediation. However, at this level, gender did serve as a moderator. The stronger mediation found for women was driven by a stronger association between sexual satisfaction and PPR for women than for men. This study joins a growing literature highlighting the role of PPR in dyadic relationships.

Men’s sexually aggressive behavior potentially could relate to either physiological hyporeactivity or hyperreactivity, and these two different physiological profiles could be associated with different underlying causes of sexual aggression. Thus, measurement of physiological reactivity could provide insight into mechanisms relevant to the etiology of sexual aggression. The relationship between sexual aggression and physiological reactivity was investigated in 78 community men (38 sexually aggressive and 40 non-aggressive men). In a laboratory protocol, the men were exposed to neutral, negative-affect-inducing, and positive-affect-inducing stimuli. Men’s salivary cortisol concentrations and electrodermal activity (EDA) were measured throughout the laboratory procedure. Sexually aggressive men demonstrated (1) lower overall cortisol levels and (2) lower EDA reactivity in some conditions as compared to non-aggressive men. Results of this study were consistent with the idea that men’s sexual aggression is associated with physiological hyporeactivity, a physiological profile that has been found to be associated with externalizing behaviors and psychopathic traits.

The present study examined men and women’s sexual and affective responses to erotic film clips that were combined with different fantasy instructions. Men (n = 29) and women (n = 28) were presented with two types of erotic films (explicit vs. romantic) and two fantasy instructions (fantasizing about one’s real-life partner vs. fantasizing about someone else). Genital response, subjective sexual arousal, and affective responses were assessed. Sexually explicit stimuli resulted in larger genital responses; women reported higher subjective sexual arousal than men; and fantasizing about one’s partner resulted, overall, in higher subjective sexual arousal and higher levels of positive affect. Moreover, in women, the instruction to fantasize about one’s partner resulted in stronger subjective sexual arousal to the explicit film than the instruction to fantasize about someone else. Results suggested that physiological, subjective, and affective responses to erotic film stimuli are impacted not only by stimulus characteristics but also by the viewer’s interpretation of the depicted relationship.

Sexual arousal is an emotional/motivational state that can be triggered by internal and external stimuli and that can be inferred from central (including verbal), peripheral (including genital), and behavioral (including action tendencies and motor preparation) responses. This article, while focusing on sexual arousal in men, provides a conceptual analysis of this construct, reviews models of sexual arousal, and discusses the usefulness of perspectives derived from motivation and emotion research in improving our understanding of its determinants and behavioral correlates. In this, it considers the role of genital feedback in men's subjective sexual arousal and the connections between sexual arousal and sexual desire. Future research and definitions may increasingly focus on its central integrative functions (as opposed to its input and output characteristics). Yet, the study of sexual arousal can be expected to continue to benefit from the measurement of its genital, verbal, and behavioral components. Instances of discordance between response components suggest that they are, at least in part, under the control of different mechanisms, and it is proposed that a better understanding of sexual arousal will prove contingent on a better understanding of such mechanisms and the conditions under which they converge and diverge.

Women with a history of childhood sexual abuse (CSA) are at greater risk for experiencing sexual problems in their adult lives. Yet, little is known about the possible role of cognitive and affective mechanisms in the development of sexual arousal difficulties in this population. This study investigated the role of pre-existing affect (affect prior to exposure to sexual stimuli) on genital responses, subjective sexual arousal, and affect elicited during the presentation of erotic film excerpts in a community sample of 25 women with and 25 women without a history of CSA. The CSA group showed greater pre-existing negative affect and smaller genital responses to the erotic film stimuli compared to the NSA group. Findings support a moderating effect of CSA, in that pre-existing negative affect was associated with strength of genital responses in the NSA but not in the CSA group. The results did not support a mediation model of pre-existing negative affect as an explanation for smaller physiological sexual responses in the CSA group. Taken together, the findings suggest that pre-existing affect may be more relevant for women with no history of CSA and call for more research on factors implicated in impaired sexual responses in women with a history of CSA.

The sexual response includes an emotional component, but it is not clear whether this component is specific to sex and whether it is best explained by dimensional or discrete emotion theories. To determine whether the emotional component of the sexual response is distinct from other emotions, participants (n = 1099) rated 1450 sexual and non-sexual words according to dimensional theories of emotion (using scales of valence, arousal, and dominance) and according to theories of basic emotion (using scales of happiness, anger, sadness, fear, and disgust). In addition, ratings were provided for newly developed scales of sexual valence, arousal, and energy. A factor analysis produced four factors, together accounting for 91.5% of the variance in participant ratings. Using logistic regression analysis, we found that one word category or factor, labeled “sexual,” was predicted only by the new sexual arousal and energy scales. The remaining three factors, labeled “disgusting,” “happy,” and “basic aversive” were best predicted by basic (or discrete) emotion ratings. Dimensional ratings of valence, sexual valence, and arousal were not predictive of any of the four categories. These results suggest that the addition of sexually specific emotions to basic emotion theories is justified and needed to account fully for emotional responses to sexual stimuli. In addition, the findings provide initial validation for the Indiana Sexual and Affective Words Set (ISAWS), supporting its use in future studies.

Women’s sexual decision making is a complex process balancing the potential rewards of conception and pleasure against the risks of possible low paternal care or sexually transmitted infection. Although neural processes underlying social decision making are suggested to overlap with those involved in economic decision making, the neural systems associated with women’s sexual decision making are unknown. Using fMRI, we measured the brain activation of 12 women while they viewed photos of men’s faces. Face stimuli were accompanied by information regarding each man’s potential risk as a sexual partner, indicated by a written description of the man’s number of previous sexual partners and frequency of condom use. Participants were asked to evaluate how likely they would be to have sex with the man depicted. Women reported that they would be more likely to have sex with low compared to high risk men. Stimuli depicting low risk men also elicited stronger activation in the anterior cingulate cortex (ACC), midbrain, and intraparietal sulcus, possibly reflecting an influence of sexual risk on women’s attraction, arousal, and attention during their sexual decision making. Activation in the ACC was positively correlated with women’s subjective evaluations of sex likelihood and response times during their evaluations of high, but not low, risk men. These findings provide evidence that neural systems involved in sexual decision making in women overlap with those described previously to underlie nonsexual decision making.

The purpose of this study was to determine if self-identified bisexual, heterosexual, and homosexual men show differential genital and subjective arousal patterns to video presentations of bisexual, heterosexual, male homosexual, and lesbian sexual interactions. It was predicted that, relative to heterosexual and homosexual stimuli, bisexual men would show the highest levels of sexual arousal to bisexual erotic material, while this stimulus would induce relatively low levels of response in heterosexual and homosexual men. A sample of 59 men (19 homosexual, 13 bisexual, and 27 heterosexual) were presented with a series of 4-min sexual videos while their genital and subjective sexual responses were measured continuously. Bisexual men did not differ significantly in their responses to male homosexual stimuli (depicting men engaging in sex) from homosexual men, and they did not differ significantly in their responses to heterosexual (depicting two women, without same-sex contact, engaged in sex with a man) and lesbian (depicting women engaging in sex) stimuli from heterosexual men. However, bisexual men displayed significantly higher levels of both genital and subjective sexual arousal to a bisexual stimulus (depicting a man engaged in sex with both a man and a woman) than either homosexual or heterosexual men. The findings of this study indicate that bisexuality in men is associated with a unique and specific pattern of sexual arousal.

In this article we report on the findings of a two-part project investigating contemporary issues in sexuality researchers' interaction with journalists. The goal of the project was to explore best practices and suggest curricular and training initiatives for sexuality researchers and journalists that would enhance the accurate dissemination of sexuality research results in the media. We present the results of a survey of a convenience sample of 94 sexuality researchers about their experiences and concerns regarding media coverage and a summary of the main themes that emerged from an invitational conference of sexuality researchers and journalists. In addition, we present some preliminary recommendations for training and best practices. Topics assessed include reporting accuracy; sex researchers' comfort with various topics, media, and journalists; researchers' perceptions of the purpose and content of articles; concern about the impact of media coverage; and training for sexuality researchers.

The past few years have seen an increased awareness of the relevance of studying the role of sexual response, emotion, and traits such as sensation seeking and the propensity for sexual inhibition in risky sexual behavior. The current study examined the association between self-reported sexual risk taking and psychophysiological response patterns in 76 heterosexual and homosexual men. Measures included genital, electrodermal, startle eyeblink, and cardiovascular responses, and stimuli included threatening (depicting coercive sexual interactions) and nonthreatening (depicting consensual sexual interactions) sexual film excerpts. Sexual risk taking was hypothesized to be associated with decreased inhibition of sexual arousal and hyporeactive affective and autonomic responses to threatening sexual stimuli. Controlling for age and number of sexual partners in the past year, sexual risk taking (number of partners during the past 3 years with whom no condoms were used) was found to be associated with stronger genital responses and smaller eyeblink responses to both threatening and nonthreatening sexual stimuli. Correlations between genital and subjective sexual arousal were relatively low. Sexual risk taking was related to sensation seeking but not to the propensity for sexual inhibition. The findings suggest that risky sexual behavior may involve a role for psychophysiological mechanisms that are specific to sex as well as for ones that are associated with more general approach/avoidance response tendencies.