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This doctoral thesis focuses on sexual self-esteem in women, which has been studied mainly in populations affected by specific problems (bulimia, etc.). Based on the analysis of the factors influencing female sexual self-esteem, the objective of this thesis is to propose a better understanding of the cognitive, bodily and societal factors involved in its genesis and maintenance. This thesis shows the importance of the subjective view that women have of their bodies and the impact of this view on their sexual self-esteem. It also highlights the impact of the mass media on the construction of body image. Through three researches, we studied the impact of physical satisfaction on women's sexual self-esteem as well as the elements on which it is based. Our different results have shown that « the relationship to the sexualized body » may be central to the conceptualization of women's sexual self-esteem. We constructed a new aggregate called the « Sexualized Body Perception » and then calculated its moderating and/or mediating effects on women's sexual self-esteem. Finally, we proceeded to the validation of this Sexualized Body Perception., (PSYE - Sciences psychologiques et de l'éducation) -- UCL, 2021

INTRODUCTION This study examines the effectiveness of integrating mindfulness-based techniques within therapy for women suffering to achieve orgasm. Although widely applied in psychotherapy, this approach has only recently been introduced in the treatment of female sexual dysfunction. AIM To compare the effectiveness of a video-based self-administered treatment, rooted within the cognitive behavioral treatment (CBT) framework, with a video-based self-administered mindfulness treatment applying cognitive behavioral sexual therapy (mindfulness-based cognitive therapy), the latter of which was specifically created to increase women's ability to achieve orgasm. METHODS A convenience sample of 65 women suffering from difficulties to achieve orgasm, aged 18 to 58 years (mean = 32.66, standard deviation = 9.48), were randomly allocated using a randomization procedure to either a mindfulness-based cognitive therapy (N = 35) or CBT (N = 30) group. Each participant completed questionnaires before and after the start of treatment and 2 months after its completion. MAIN OUTCOME MEASURE We applied repeated-measure general linear models to compare the 2 groups (ie, between participant factor) on each dependent variable across time (ie, the within-participant factor). Compare mean analyses for paired samples were only conducted when the interaction effect between condition and time was significant (ie, P <.05). RESULTS Statistical analyses show that women in both groups presented increased sexual functioning ( P = .001) and decreased sexual distress ( P < .001), as well as improved desire, arousal, orgasm, and sexual satisfaction ( P < .05) after their respective treatments. Contrary to our hypothesis, significant reductions in sexual pain were only observed in CBT participants. Clinical Implications To the best of our knowledge, this is the first study to apply a randomized allocation procedure to evaluate the effectiveness of a video-based mindfulness intervention for women stru

With the democratization of the Internet in the early 2000s, countless sexual sites have emerged. Their number is constantly increasing, becoming more and more interactive and immersive with the evolution of digital technologies. Following this expansion and democratization of access to various types of sexual content/material on the Internet, requests for psychological treatment related to the excessive use of online sexuality are on the rise and researchers started to study this phenomenon. This thesis aims to focus on the use of online sexuality, and particularly on people for whom this consumption has become problematic, out of control and results in negative consequences and functional impairment. More specifically, we are interested in the risk factors involved in the development and perpetuation of a problematic use, and this, in order to better conceptualize this condition and therefore propose tailored and process-based psychological treatments., (PSYE - Sciences psychologiques et de l'éducation) -- UCL, 2019

OBJECTIF L’anorgasmie féminine est une des difficultés sexuelles les plus fréquentes. La pleine conscience (PC) est souvent utilisée en psychopathologie et son efficacité a été largement prouvée scientifiquement. L’objectif de cet article est de comprendre l’intérêt d’intégrer la PC dans le traitement du trouble de l’orgasme féminin. Dans cette perspective, nous présentons une revue de la littérature du trouble de l’orgasme féminin et ses traitements. Ensuite, la pleine conscience et son efficacité pour les dysfonctions sexuelles féminines sont abordées. La discussion permet de mettre en avant l’intérêt d’intégrer la PC dans le traitement du trouble de l’orgasme féminin. MATÉRIEL ET MÉTHODE Analyse de la littérature de 1952 à 2018 effectuée principalement dans les bases de données Sciencesdirect et Scopus avec comme mots clés mindfulness, female orgasmic disorder, anorgasmia, women sexual dysfonction. RÉSULTATS La PC est efficace pour les traitements des troubles psychopathologiques et son utilisation s’est étendue aux difficultés sexuelles féminines. Si plusieurs traitements de l’anorgasmie se sont focalisés sur l’amélioration des habilités comportementales et la réduction de l’anxiété, peu se sont consacrés aux cognitions et aux émotions dysfonctionnelles responsables du trouble de l’orgasme féminin. Au regard de la littérature, la PC améliore toute la fonction sexuelle féminine. CONCLUSION La PC propose des exercices qui faciliteraient l’atteinte de l’orgasme. Cette étude souligne l’intérêt d’intégrer la PC dans la prise en charge du trouble de l’orgasme féminin et d’élaborer d’un protocole de traitement directement utilisable par les cliniciens., [Mindfulness-based therapy for women's orgasmic disorder] PURPOSE Orgasmic disorder is one of the most common sexual women's difficulties. Mindfulness is often used in psychopathology and its effectiveness has been widely proven scientifically. The purpose of this article is to understand the interest to integrate mindfulness training in the treatment of female orgasmic disorder. In this perspective, we present a review of the literature on female orgasm disorder and its treatments. Moreover, mindfulness and its effectiveness for female sexual dysfunctions are addressed. The discussion highlights the value of integrating mindfulness into the treatment of female orgasm disorder. SOURCES AND METHODOLOGY A review of the literature about mindfulness and anorgania will be presented. We investinguate mostly studies from 1952 to 2018 using Scopus and ScincesDirect data base with the keywords Mindfulness, female orgasmic disorder, anorgasmia, female sexual dysfonction. RESULTS Mindfulness is effective for many psychopathological disorders and its use has extended to female sexual difficulties. While several treatments for anorgasmia have focused on improving behavioral skills and reducing anxiety, few have focused on the cognitions and dysfunctional emotions that are responsible on the female orgsmic disorder. The review of the literature shows that mindfulness improves all female sexual function. Furthermore, it would be interesting to integrate mindfulness for the female orgasm disorder and develop a specific treatment directly usable by clinicians. CONCLUSION Mindfulness includes exercises to develop abilities to achieve orgasm. This study suggests that future research might develop a mindfulness-based therapy protocol to treat women's orgasmic disorder.

People confronted to a stressful life event may experience negative consequences on sexual intimacy (Morokoff & Gillilland, 1993; Hagemeister & Rosenblatt, 1997, Bodenmann, Ledermann, et al., 2006). The main hypothesis of the study is that the impact of stressful events on sexuality, especially on sexual desire, will depend on the subjective reactions to this event. 52 women responded to several questionnaires: the sexual desire scale, the impact of event scale-revised (IES-R) and a list of potential stressful events. The results showed a positive association between the stressful event and dyadic sexual desire. Especially, women who experienced high levels of intrusions and hyperarousal after a stressful event also exhibited a higher levels dyadic sexual desire, with no significant result for individual sexual desire.

Up until today, with the exception of the Wiederman and Hurst study in 1998, no research has been done with regard to the relationship between women's sexual self-esteem, body mass index, physical satisfaction and body image. Through two studies done on adult women, our objective was to better understand the impact of physical satisfaction on women's sexual self-esteem as well as investigate the elements on which the latter is founded. Data from the first study seem to indicate that BMI would be correlated in a negative and moderate manner to women's sexual self-esteem. A clearer relationship, however, is observed between sexual self-esteem and body/physical satisfaction. Results from the second study indicate no relationship between BMI and sexual self-esteem but they do, however, indicate a relationship between sexual self-esteem and body image/esteem. Furthermore, the most salient traits of attractiveness/seduction were found to be related to the face (eyes, lips, smile). Altogether, research results seem to suggest that “relationship to the body” may be central to women's conceptualization of sexual self-esteem.

CONTEXTE Outre le fait que la solitude soit un facteur de risque pour la santé de l’individu, de nombreux patients expriment leur difficulté à engager une relation amoureuse. La création d’un lien affectif passe nécessairement par une phase de séduction. Cet article a donc pour objectif de présenter un état des lieux des recherches menées sur la séduction afin de relever les habiletés qui peuvent être travaillées et ainsi améliorer les interventions thérapeutiques des professionnels. MATÉRIEL ET MÉTHODE Analyse de la littérature de 1967 et 2017 dans les bases de données Scopus, PsycInfo et SciencesDirect en utilisant les mots clefs suivants : seduction, human, courtship, female, male et pheromone. RÉSULTATS La séduction est composée d’aspects physiologiques, a priori immuables, mais également d’aspects psychologiques sur lesquelles il est possible d’agir. Cependant, si les premiers aspects font l’objet d’une littérature abondante, les seconds sont quant à eux encore peu approfondis. CONCLUSION Actuellement, il existe encore peu d’article portant sur le versant psychologique et modulable de la séduction. Malgré tout, la littérature existante nous offre des pistes intéressantes sur les habiletés de séduction qui peuvent être travaillées afin de favoriser la rencontre amoureuse., [Can we improve our seduction skills?] PURPOSE Solitude and social isolation are correlated with most risk of suicide, depression and alcoholism. Affective link is a protective factor for human well being. To create an affective link, people have to initiate a courtship phase. However, many patients seem to be showing difficulty to seduce a partner. The purpose of this article is to investigate seduction characteristics in order to highlight what skills should be improved to facilitate the seduction phase. The initial section gives the definition of seduction and a brief history of his evolution. The influence of culture shall be also discussed. The second section gives information about biological and physiological aspects of seduction. Finally, the third section is focused on psychological aspects. SOURCES AND METHODOLOGY A review of the literature about seduction will be presented. We investigate studies from 1967 to 2017 using Scopus and SciencesDirect and PsycInfo data base with the keywords seduction, human, courtship, female, male and pheromone. RESULTS Seduction includes biological and psychological aspects. Most studies are focused on biological aspect. Nevertheless, these factors cannot be modified because they are part of our human genetic inheritance. But psychological aspects give keys to improve seduction skills. Psychological aspects are composed of cognitive, emotional and behavioral dimensions. These dimensions can be improved with patients during therapy. CONCLUSION Studies might be more focused on psychological aspects of seduction because they can be improved and worked with patients.

OBJECTIFS : Cet article s’intéresse aux facteurs cognitifs responsables du trouble de l’orgasme et plus spécifiquement à la distraction cognitive ainsi que le rôle de l’attention dans l’atteinte de l’orgasme féminin. Le premier objectif est de présenter les déterminants du trouble de l’orgasme et plus particulièrement les déterminants psychologiques. Le deuxième objectif est de présenter les facteurs cognitifs dans les dysfonctions sexuelles féminines en vue de mieux comprendre le rôle des schémas cognitifs sexuels, des pensées automatiques négatives et des émotions négatives associées. Ensuite, il définit et conceptualise la distraction cognitive d’après le modèle de Barlow (1986) afin d’évaluer son impact sur la réponse sexuelle féminine et plus particulièrement chez les femmes anorgasmiques. Il présente aussi le rôle de l’attention dans l’atteinte de l’orgasme. Finalement, il tente de concrétiser le cercle vicieux du trouble de l’orgasme d’après une analyse processuelle. Cet article devrait permettre de réfléchir sur les stratégies sexothérapeutiques à mettre en place dans la prise charge du trouble de l’orgasme féminin. MATÉRIEL ET MÉTHODE : Analyse de la littérature de 1970 à 2015 dans la base de données scopus avec comme mots clefs : anorgasmie, attention, distraction et dysfonction sexuelle. RÉSULTATS : Au regard de la littérature, les femmes anorgasmiques présentent davantage d’autoschémas sexuels négatifs ainsi que des pensées et des émotions négatives qui interfèrent avec l’atteinte de l’orgasme. Dans cette perspective, c’est l’analyse processuelle et non le diagnostic qui va guider les interventions sexothérapeutiques du trouble de l’orgasme. Celles-ci devraient principalement se centrer sur les processus dysfonctionnels (évitement expérientiel, biais cognitifs attentionnels, gestion des pensées et émotions négatives) dans la perspective de diminuer l’appréhension anxieuse, les émotions secondaires et ainsi faciliter l’atteinte de l’orgasme. CONCLUSION, [Process-analysis of cognitive factors of female orgasm disorder] PURPOSE : This article focuses on the cognitive factors responsible for orgasmic disorder and, more specifically, on the cognitive distraction and the role of attention in achieving female orgasm. First and foremost, we want to present the determinants of orgasm disorder and especially the psychological determinants. Secondly, we aim at presenting the cognitive factors in sexual dysfunctions in order to have a better understanding of the role of sexual cognitive patterns, negative automatic thoughts and associated negative emotions. Afterwards, this article defines and conceptualizes cognitive distraction following Barlow's model (1986). The purpose is to evaluate its impact on the female sexual response, with a particular emphasis on anorgasmic women. It presents the role of attention in achieving orgasm as well. Finally, one tries to present a concrete conceptualization of the orgasm disorder cycle of after a process-analysis. This article should raise reflection on sexotherapeutic strategies to implement in order to tackle female orgasm disorder. MATERIAL AND METHOD : An analysis of the literature since 1970 until 2015 in the scopus database with the following keywords: anorgasmia, attention, distraction and sexual dysfunction. RESULTS : After a thorough review of the literature, it appears that anorgasmic women have more negative sexual self-schemas as well as negative thoughts and emotions, which interferes with the orgasm achievement. Bearing this in mind, it is the process-analysis, and not the diagnosis, that will guide sexotherapeutic interventions in orgasmic disorder. These should mainly focus on dysfunctional processes (experiential avoidance, cognitive attentional bias, dealing with negative thoughts and emotions) in order to reduce anxious apprehension, secondary emotions and therefore facilitate the achievement of orgasm. CONCLUSION : In further studies, it would be interesting to propo

OBJECTIFS : Face à l’épidémie du sida et de nombreuses infections sexuellement transmissibles, les préservatifs constituent une meilleure et durable stratégie de prévention. Cependant, la population sexuellement active du Burundi utilise beaucoup moins ce mode de prévention. Ce qui explique en partie pourquoi la prévalence de ces maladies reste plus élevée au sein de cette population. L’objectif de cet article est de relever les raisons de la faible utilisation du préservatif par la population du Burundi. MÉTHODE : Analyse de la revue de la littérature locale et internationale sur le VIH et l’usage des préservatifs. RÉSULTATS : Les principaux facteurs de non-usage des préservatifs sont les suivants : les préservatifs diminuent le plaisir sexuel, ils sont gênants, ils créent des suspicions entre partenaires connus et ne sont pas fiables. Aussi, lorsque les relations sexuelles ont lieu au gré des rencontres, souvent le préservatif ne trouve pas sa place. Par ailleurs, pour une majorité de Burundais, les préservatifs ne seraient éventuellement utiles que lorsqu’il s’agit des partenaires occasionnels. Mais s’il s’agit d’une liaison plus ou moins durable, il n’est pas utilisé. Des gens enfin, se sachant infectés n’utilisent pas les préservatifs pour contaminer sciemment les jeunes partenaires. En effet, il existe des croyances que le soi-disant « sang sain » pourrait guérir. Ou alors, il s’agit de partager une souffrance psychologique causée par leur état de séropositivité. CONCLUSION : Envisager une éducation à la santé sexuelle de masse, sensibiliser les hommes qui utilisent divers moyens pour avoir des rapports sexuels non protégés avec les jeunes serait une bonne stratégie de prévention., [Factors influencing low condom use by Burundi's sexually active population] OBJECTIVES : Faced with the AIDS epidemic and many sexually transmitted infections, condoms are a better and lasting prevention strategy. However, the sexually active population of Burundi uses much less this type of prevention. This explains in part why the prevalence of these diseases remains higher in this population. The objective of this article is to highlight the reasons for the low condom use by the population of Burundi. METHOD : Analysis of the review of the local and international literature on HIV and condom use. RESULTS : The main factors of non-use of condoms are the following: condoms diminish sexual pleasure, they are troublesome, they create suspicions between known partners and are not reliable. Also, when sexual intercourse takes place according to the encounters, often the condom does not find its place. Moreover, for a majority of Burundians, condoms would only be useful if they were occasional partners. But if it is a more or less durable bond, it is not used. People, knowing themselves to be infected, do not use condoms to deliberately infect young partners. Indeed there are beliefs that the so-called “healthy blood” could cure. Or, it is a question of sharing a psychological suffering caused by their state of seropositivity. CONCLUSION : Considering mass sexual health education, educating men who use various means to have unprotected sex with young people would be a good prevention strategy.

Le concept de désir sexuel n’est pas aisé à définir et encore moins à évaluer. Pourtant, un nombre important de femmes souffrent d’une baisse de libido, constituant ainsi une des plaintes principales reçue en consultation sexologique. Conséquence de cette difficulté de conceptualisation du désir, de nombreux questionnaires sont proposés aux praticiens. Il n’est donc pas aisé de déterminer quelle mesure choisir pour l’évaluation du désir. L’objectif de cet article est de développer 4 questionnaires traduits en français et mis en place pour évaluer la sévérité des symptômes du trouble du désir sexuel, le niveau de désir ou les réactions psychologiques qui lui sont consécutives. Les propriétés psychométriques, les forces ainsi que les limites de 4 échelles seront présentés : l’Échelle du Désir Sexuel (Tremblay et Roussy, 2000), le Derogatis Sexual Functioning Inventory (Derogatis et Meliseratos, 1979), l’histoire sexuelle du système multiaxial d’évaluation des dysfonctions sexuelles (Schover et al., 1982) et le Female Sexual Function Index (Meston, 2003). Cette brève analyse amène à conclure que le Female Sexual Function Index semble être un outil de mesure pertinent pour l’évaluation globale du fonctionnement sexuel féminin. En ce qui concerne la dimension spécifique du désir sexuel, l’échelle du désir sexuel paraît offrir la mesure la plus satisfaisante. Cependant, il apparaît également que les questionnaires francophones actuellement développés pour l’évaluation du désir sexuel chez la femme souffrent d’un manque de validation empirique. Ce domaine de recherche offre donc beaucoup de perspectives futures., The concept of sexual desire is not easy to define, and even less to assess. However, a significant number of women suffer from a decrease in libido, thus constituting one of the main complaints received in sexological consultation. Consequence of the difficulty of conceptualization, many questionnaires are available to clinicians. Therefore, it is not easy to determine how to choose the assessment of desire. The aim of this paper is to develop four questionnaires translated in French and implemented to assess the severity of the symptoms of the disorder of sexual desire, the level of desire or psychological reactions that are consecutive. The psychometric properties, the forces as well as the limits of 4 scales will be presented: the Scale of Sexual Desire (Tremblay and Roussy, 2000), Derogatis Sexual Functioning Inventory (Derogatis and Meliseratos, 1979), the sexual history of the multiaxial system of sexual dysfunction (Schover et al., 1982) and the Female Sexual Function Index (Meston, 2003). This brief analysis leads to the conclusion that the Female Sexual Function Index seems to be a relevant measurement tool for the overall evaluation of the female sexual function. With regard to the specific dimension of sexual desire, the scale of sexual desire seems to provide the most satisfactory measure. However, it also appears that the francophone questionnaire currently being developed for the assessment of sexual desire in women suffer from a lack of empirical validation. This research area offers many future prospects.

It has been recently demonstrated that mindfulness-based intervention may be particularly suitable for addressing sexual difficulties in women. Although the Five-Facet Mindfulness Questionnaire (FFMQ) is currently one of the most widely used scales to assess mindfulness, no adaptation and validation of the FFMQ to measure female sexual functioning has been published. The main aim of this study was to develop and validate a sexual version of the Five Facets Mindfulness Questionnaire (FFMQ-S) to specifically measure mindfulness in the context of sexual encounters. A total of 251 healthy, French-speaking female volunteers were administered the FFMQ-S, the original FFMQ, and the Female Sexual Distress Scale (FSDS-R). Confirmatory factor analyses indicated that the FFMQ-S exhibits a five-factor model, as implied by the original FFMQ. Good scale reliability was observed. The FFMQ-S showed significant correlations with the FSDS-R and the usual FFMQ. Scores on the FFMQ-S correlated significantly more negatively with the total FSDS-R score than with the total score of the original version of the FFMQ. These findings clearly support the relevance of developing a version of the FFMQ tailored to sexual functioning. © 2014 Copyright The Society for the Scientific Study of Sexuality.

Objectives: The initial section of this article gives an historical perspective to the concept of orgasm. Various models of the female sexual response are then presented, with the objective of seeking a definition of the female orgasm. Finally, the concept of female orgasmic dysfunction is explored through the differing versions of DSM whilst providing a critical overview. Sources and methodology: Analysis of the literature from 1950 to 2013 using the Scopus database with the keywords: anorgasmia; female and sexual dysfunction. Outcome: The data suggests there is no universally accepted definition of the female orgasm to date (Mah and Binik, 2001). Numerous studies focus on the physiological aspect of the orgasm whilst the psychological factors are researched to a lesser degree. The lack of a satisfactory definition of the orgasm may be attributed to the limited understanding of its underlying mechanisms, and to the fact that the researchers are dependent on the women's subjective self-evaluation of the experience. Thus, the subject is complex, with some women incapable of giving expression to their orgasmic experience or even recognising such climax. In some cases, this is because they have indeed never experienced one; in other cases, because they have not thought of it as an orgasm. Orgasmic dysfunction or anorgasmia is the second sexual problem most frequently encountered by women with a prevalence ranging from 25 (Lewis et al., 2010) to 31% (Hayes et al., 2006). Conclusion: It would be interesting for future studies to research the ways in which women experience at the cognitive and emotional level their sexual relations with their partner. This should enable us to better understand and define the female orgasm but also to improve support for orgasmic dysfunction.

Mindfulness was studied in relation to sexual distress and the ability to achieve orgasm. The initial hypotheses were that mindfulness abilities would predict women's level of sexual distress and that orgasmic women would possess greater mindfulness skills. In total, 251 women (176 orgasmic women and 75 anorgasmic women) responded to several questionnaires online: the Female Sexual Distress Scale – Revised (FSDS-R), the Five-Facet Mindfulness Questionnaire (FFMQ), and the Sexual Five-Facet Mindfulness Questionnaire (FFMQ-S). According to our results, mindfulness during dyadic sexual activities (FFMQ-S) explained 54% of the variability in sexual distress (FSDS-R). Overall, orgasmic women reported more mindfulness than anorgasmic women, both in daily life (FFMQ) and significantly more during dyadic sexual activities (FFMQ-S). In conclusion, our results support the evaluation of women's level of mindfulness during dyadic sexual activities and the integration of mindfulness training in future sex therapy treatments.

La sexologie est une discipline en plein développement car l’évolution des mœurs va vers une demande d’aide croissante des patients souffrant de dysfonctions sexuelles. Il existe actuellement encore de nombreuses cliniques et hôpitaux en Belgique qui n’ont pas de sexologue. Plusieurs régions de Wallonie sont dépourvues de sexologues universitaires. Cet article vise à mieux comprendre les offres de formations existantes à l’UCL., Sexology is a discipline in full development because the evolution of morals is going toward a growing demand for help patients suffering from sexual dysfunction. Actually, there are still many clinics and hospitals in Belgium which do not have a sexologist. Several regions of Wallonia are devoid of qualified sexologists. This article aims to better understand the offerings of existing training courses at Université catholique de Louvain in Belgium

Il est intéressant pour le sexologue clinicien de bien comprendre le fonctionnement des femmes orgasmiques afin de mieux appréhender les problématiques d’anorgasmies. L’orgasme constitue l’étape la moins bien comprise de la réponse sexuelle féminine, sa description est trop souvent subjective et les chemins pour y parvenir sont multiples. Actuellement, le trouble de l’orgasme est la deuxième difficulté sexuelle la plus fréquemment rencontrée par les femmes et représente une large proportion des consultations en sexologie. Dix-huit à 41 % des femmes présenterait des difficultés à atteindre l’orgasme. Par ailleurs, l’anorgasmie serait davantage présente lors des activités sexuelles dyadiques que solitaires. Dans cette perspective, cette enquête en ligne s’intéresse spécifiquement aux émotions, aux pensées et aux stimulations responsables de l’atteinte de l’orgasme durant les activités sexuelles solitaires (autostimulation) et de couple (dyadiques). L’étude porte sur un échantillon de 251 femmes tout venant dont 176 se décrivent comme « orgasmiques » et 75 comme « pas orgasmiques ». Comparativement aux femmes anorgasmiques, les femmes orgasmiques présentent davantage de plaisir et moins de détresse sexuelle. Elles ont aussi plus recours à leurs pensées érotiques durant les activités sexuelles dyadiques et semblent plus centrées sur leurs sensations corporelles et sur leur partenaire. De plus, les femmes orgasmiques ont recours à un panel de comportements érotologiques plus large. Nos résultats devraient permettre d’améliorer le traitement de l’anorgasmie notamment durant les activités sexuelles dyadiques.

It is important for clinical sexologists to understand the functioning of orgasmic women in order to better comprehend the issues of anorgasmia. The orgasm constitutes the most poorly understood step of the female sexual response, its description is too often subjective, and there exist many paths to reach orgasm. At present, difficulty achieving orgasm is the second most common sexual problem experienced by women and represents a large proportion of consultations in sexology. According to the studies of Laumann et al. (2005), 18 to 41% of women experience difficulties achieving orgasm. Moreover, anorgasmia may be more present during dyadic sexual activities than solitary ones. In this perspective, this online study was primarily interested in emotions, thoughts, and stimulations responsible for achieving orgasm during solitary sexual activities (self-stimulation) and during sexual activities with a partner (dyadic). The study sample consisted of 251women, of which 176 described themselves as "orgasmic" and 75 as "non-orgasmic." Compared to non-orgasmic women, orgasmic women reported more pleasure and less sexual distress. They also resorted to erotic thoughts during dyadic sexual activities and seemed more centered on their bodily sensations and on their partner. Additionally, orgasmic women reported using a larger variety of erotological behaviors. Our findings may help to improve the treatment of anorgasmia, especially during dyadic sexual activities.

La médiatisation récente de cas d’addiction sexuelle a mis au jour cette pathologie longtemps méconnue, en butte à de nombreuses idées reçues : « L’addiction sexuelle est surtout un problème d’homme », « La pratique d’une sexualité addictive entre adultes consentants n’entraîne aucune conséquence néfaste », « Tous les addictifs sexuels sont des agresseurs sexuels », « Les thérapeutiques médicamenteuses et hormonales constituent de bons traitements de l’addiction sexuelle »… Loin des faits divers, à partir d’une étude clinique précise, rappelant les aspects historiques et sociologiques, les auteurs nous permettent de mieux comprendre les différentes facettes de cette souffrance, les conséquences pour les malades, mais aussi pour les victimes, et les thérapies disponibles à ce jour. Quentin Debray est professeur de psychiatrie honoraire de l’Université Paris Descartes (Paris V). Pascal de Sutter est professeur de psychologie, clinicien, spécialisé en sexologie à l’Université catholique de Louvain. Thierry H. Pham est docteur en psychologie. Il enseigne aux universités de Mons et de Québec Trois-Rivières. Patrice Louville est psychiatre, responsable d’une unité d’addictologie dans le pôle Psychiatrie-Addictologie des Hôpitaux universitaires Paris Ouest.

Interest. — Hypoactive desire disorder is a widespread difficulty among women. The concept of sexual desire and its dysfunctions are difficult to define because they involve an important subjective dimension. Due to this subjective component, psychological factors, and in particular cognitive dimensions, are hypothesized to play an important role in the development and maintenance of sexual dysfunctions. The processes at hand seem complex and conflicting positions exist. They will be reviewed with the aim to clarify the different propositions related to the role of cognitive processes in play in women sexual dysfunctions, especially hypoactive sexual desire. Future targets of therapeutic interventions will accordingly be proposed. Method. — A review of the literature about cognitive factors in women sexual dysfunctions and hypoactive desire disorder will be presented. This review has been completed mostly from PsycInfo and Medline research engines, focusing on studies from last 1970s to 2011. Most of the inventoried researches used the DSM-IV-TR (2000) criteria’s to establish the diagnosis of hypoactive sexual desire disorder. Empirical studies reported used principally clinical and control samples. The main keywords were: sexual desire, sexuality, cognitive, beliefs and thoughts. Results. — In general female population, prevalence of hypoactive sexual desire ranges from 24 to 43%. Causal factors of this problematic could be biological, environmental or psychological. Among psychological factors, literature shows that negative cognitions play an important function in women sexual dysfunctions. These cognitive factors are composed of three main levels that allow information processing in sexuality and also in all domains of life. Clinicians and researchers are agree to say that women suffering from sexual dysfunctions present more negative beliefs (e.g., older people can not have sexual intercourses, sexuality can only be used for reproduction) compared to women with

Intérêt Le désir sexuel hypoactif (DSH) est une difficulté largement répandue parmi les femmes. Le concept de désir sexuel ainsi que ses dysfonctionnements sont difficiles à définir en raison de la dimension subjective importante. À cause de cette composante subjective, les facteurs psychologiques, et en particulier les dimensions cognitives, sont susceptibles de jouer un rôle important dans le développement et le maintien des dysfonctions sexuelles. Les processus à l’œuvre apparaissent complexes et des positions contradictoires existent. Elles seront passées en revue avec comme objectif de clarifier les différentes propositions liées au rôle des processus cognitifs en jeu dans les dysfonctions sexuelles féminines, particulièrement dans le DSH. Les futures cibles des interventions thérapeutiques seront également proposées. Méthode Une revue de la littérature des facteurs cognitifs dans les dysfonctions sexuelles et le DSH sera présentée. Ce tour de la littérature s’est effectué essentiellement à partir des moteurs de recherche PsycInfo et Medline, en s’intéressant aux études parues dès la fin des années 1970 jusqu’à 2011. La plupart des recherches recensées utilisent les critères du DSM-IV-TR (2000) pour établir le diagnostique de DSH. Les études empiriques relatées utilisent essentiellement sur des échantillons cliniques et contrôles. Les principaux mots-clés étaient : sexual, desire, sexuality, cognitive, beliefs and thoughts. Résultats Dans la population féminine générale, la prévalence du DSH se situe entre 24 et 43 %. Les facteurs à l’origine de cette problématique peuvent être biologiques, environnementaux ou psychologiques. Parmi les facteurs psychologiques, la littérature montre que les cognitions négatives jouent un rôle important dans les dysfonctions sexuelles féminines. Ces facteurs cognitifs sont composés de trois niveaux principaux qui vont permettre le traitement de l’information dans la sexualité mais aussi dans tous les domaines de la vie. Les clini

Objectif : Cet article a pour ambition de proposer aux cliniciens un modèle permettant le repérage des éléments dysfonctionnels responsables de l’apparition ou du maintien du Désir Sexuel Hypoactif. Méthodologie En nous appuyant sur une large recension des écrits cliniques et empiriques, nous suggérons une vision globale dont les fondements théoriques viennent de la sexofonctionnelle. Résultats : Ce modèle souligne le caractère multifactoriel du Désir Sexuel Hypoactif et nous conduit vers une structuration didactique en cinq axes. Discussion : De cette manière, les facteurs (1) cognitifs, (2) physiologiques, (3) comportementaux, (4) émotionnels et (5) environnementaux sont discutés. Conclusions : Cette étiologie en cinq axes facilitera l’évaluation de l’ensemble des éléments responsables du Désir Sexuel Hypoactif et permettra aux cliniciens une adaptation de leur traitement en fonction d’une anamnèse attentive au caractère multifactoriel du Désir Sexuel Hypoactif.

Object : The purpose of this article is to propose a model to clinicians designed to highlight the dysfunctional elements responsible for the appearance and continuation of Hypoactive Sexual Desire Disorder. Methodology : Supported by a broad analysis of clinical and empirical accounts, we suggest a global vision whose theoretical foundations come from “sexofonctionnelle”. Results :This model underlines the multi-factor aspect of Hypoactive Sexual Desire Disorder and leads us to a didactical structuration comprising five axes. Discussion : Thereby, the cognitive, physiological, behavioural, emotional and environmental factors are discussed. Conclusion : This etiology with its five axes will facilitate the assessment of all the elements responsible for Hypoactive Sexual Desire Disorder and will enable clinicians to adapt their treatment by being aware of the multi-factor nature of Hypoactive Sexual Desire Disorder when taking a medical history.

Object Bibliotherapy is a concept which leads us to consider the wide range of actual therapeutic approaches. The originality of bibliotherapy lies in the fact that the use of a writing (brochure, manual, book…) constitutes the central element of the help intervention. Methodology A review of the literature about the different types of bibliotherapeutic books, about the way these books are used, as well as about the levels of contact with the therapist will be presented. The reflection will thereafter focus on scientifically validated books dealing with female sexual dysfunctions. Results Bibliotherapy as treatment for sexual dysfunctions does not equal traditional sex therapies, but it offers an interesting and effective alternative for a specific target audience and a complementary tool to traditional methods. Discussion Different factors influencing the effectiveness of the bibliotherapeutic tool are discussed. Some reflections are also proposed to try to determine the profile of the women to whom the bibliotherapeutic tool may be advised. Conclusions It is noticed that there exists only a few bibliotherapeutic tools which have been validated for sex therapy. The promotion of further research in this field would therefore be highly pertinent in view of the positive results of previous studies.

Introduction. Research has demonstrated the association between vaginal orgasm and better mental health. Some theories of psychotherapy assert a link between muscle blocks and disturbances of both character and sexual function. In Functional-Sexological therapy, one focus of treatment is amelioration of voluntary movement. The present study examines the association of general everyday body movement with history of vaginal orgasm. Aim. The objective was to determine if appropriately trained sexologists could infer women's history of vaginal orgasm from observing only their gait. Methods. Women with known histories of either vaginal orgasm or vaginal anorgasmia were videotaped walking on the street, and their orgasmic status was judged by sexologists blind to their history. Main Outcome Measure. The concordance between having had orgasms triggered by penile-vaginal intercourse (not orgasm from direct clitoral stimulation) and raters' inferences of vaginal orgasm history based on observation of the woman's walk was the main outcome measure. Results. In the sample of healthy young Belgian women (half of whom were vaginally orgasmic), history of vaginal orgasm (triggered solely by penile-vaginal intercourse) was diagnosable at far better than chance level (81.25% correct, Fisher's Exact Test P < 0.05) by appropriately trained sexologists. Clitoral orgasm history was unrelated to both ratings and to vaginal orgasm history. Exploratory analyses suggest that greater pelvic and vertebral rotation and stride length might be characteristic of the gait of women who have experienced vaginal orgasm (r = 0.51, P < 0.05). Conclusions. The discerning observer may infer women's experience of vaginal orgasm from a gait that comprises fluidity, energy, sensuality, freedom, and absence of both flaccid and locked muscles. Results are discussed with regard to previous research on gait, the effect of the musculature on sexual function, the special nature of vaginal orgasm, and implications