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As a physiological indicator of sexual arousal, it is still unclear what these vaginal signals represent and whether they are analogues of distinct vascular processes Levine, However, there is evidence for their convergent validity. The construct of arousability is central to understanding cognitive and affective aspects of sexual excitement in women.
According to Bancroft , arousability is a cognitive sensitivity to external sexual cues. He suggests that high arousability implies enhanced perception, awareness, and processing of not only sexual cues but the bodily responses of sexual excitement. This model seeks to connect cognitive—affective responses with control of genital and peripheral indications of sexual excitement through a neurophysiological substrate for sexual arousal.
Fortunately, one of the psychometrically strongest self-report measure for female sexuality is one that also taps sexual arousability, the Sexual Arousability Index SAI by Hoon, Hoon, and Wincze On this item measure, women rate their sexual arousal for a variety of erotic and explicit sexual behaviors.
The measure samples a range of individual and partnered erotic and sexual behaviors; our psychometric studies indicate that the SAI samples the following domains: Although there is the expectation that physiologic measures, behavioral reports, and subjective reports converge, examples of dyscrony are common see Turpin, , for a discussion of assessment of anxiety disorders , so too in this area, reports are mixed.
In the Laumann et al. Other relevant data indicate that the magnitude of the correlations may be moderated by individual differences among women, such as indications of their sexual responsiveness. At this time, there is insufficient data to draw a conclusion about the significance or lack thereof of this dysyncrony. It may be useful to consider other positive affects or emotions that may influence sexual excitement—arousal.
This examination provides a way to establish convergent and discriminant validity for the excitement construct. People then label this arousal as love. A classic experiment provided evidence for this notion. Dutton and Aron had men who were between 19 and 35 years old walk across one of two bridges. One bridge was suspended over a deep gorge and swayed vigorously from side to side.
The other bridge was much more stable and was much closer to the ground. Presumably, participants would be substantially more psychophysiologically aroused by crossing the swaying bridge than by crossing the stable one. As the men walked across the bridge, they were met by a research assistant, who was either male or female and who asked the participant to answer a few questions and to tell a story based on a picture.
After the tasks were completed, the research assistant mentioned that if a participant wanted more information, he could call the assistant at home. Two important findings emerged. The first was that the stories of the participants in response to a Thematic Apperception Test card were highest in sexual imagery in the group that crossed the swaying bridge and met the female assistant. The second was that members of this condition were also the most likely to call the assistant at home, in some cases, even attempting to arrange another, more personal, meeting.
These data have been interpreted as indicating that arousal, accompanied by a plausible labeling of the arousal as love or at least attraction , seems to be one basis for passionate love see Sternberg, , for a related discussion.
Although this experiment has not been replicated with women, it illustrates the general phenomena of positive affective labeling with sexual attraction, and possibly sexual arousal. The item Passionate Love Scale by Hatfield and Sprecher is reliable and evidences broad construct validity. Passionate love, defined as an intense longing for union with another, consists of three components: The measure is correlated but not overlapping with relevant measures of sexual desire and excitement e.
Historically, anxiety has been the hypothesized mechanism in many theories of arousal deficits. Psychodynamic hypotheses emphasize fears of phallic-aggressive impulses, castration, rivalry, or incestuous object choices Janssen, More central to contemporary views, Wolpe was the first to emphasize anxiety-based impairment of physiologic responses. In his view, the sympathetic activity characteristic of anxiety inhibits the local i.
Initially offered to explain male arousal deficits, the model has been applied less satisfactorily for women. Dysfunctional attentional processes and negative affects have been the core of psychological theories of excitement deficits. Anxiety about performance failure i. Again, male sexual responding is usually the exemplar for this model. When a positive, functional sexual response e. Women are presented with stimuli, usually videotapes, representing anxiety-provoking, neutral, or erotic sequences.
Vaginal measures, as well as self-reports of general or genital arousal, are recorded. In tests of the physiologic effects of anxiety, the data have, in general, indicated that genital arousal is not inhibited by anxiety.
Using individualized, anxiety-provoking audiotaped scenarios, Beggs, Calhoun, and Wolchik , for example, found that genital arousal VBV increased during the anxiety-provoking condition, although the levels were not as high as those achieved during an erotic verbal stimulus.
Palace and Gorzalka found that preexposure with an anxiety-provoking videotape e. This effect, preexposure to an anxiety-provoking stimulus increasing subsequent VBV during erotica, has also been replicated Palace, in press. Other data disconfirming of both the Masters and Johnson and the Barlow conceptualizations is that by Laan, Everaerd, van Aanhold, and Rebel Taken together, these data suggest that these previous conceptualizations may be less relevant if relevant at all for women, as they substantiate neither the arousal processes they may be predominately sympathetic rather than parasympathetic nor hypothesized mechanisms e.
For these reasons, we consider anxiety as well as a broad band of other affects that may be relevant to discriminate from excitement processes for assessment. As an aside, we note that the DSM—IV gives no clues as to the direction of assessment and largely omits affective criteria for arousal disorder in women. Sexual anxiety, or related terms, has been used to name scales that differ considerably in content and intent.
We also note that, rather than use previously published measures, many investigators commonly develop their own sexual anxiety scales by appending a rating scale e. A procedure not unlike the latter was E. She defined anxiety as a negative feeling of tension or nervousness and used the SAI items but changed the anchors for the rating scale 7-point Likert scale ranging from — 1 [relaxing] to 5 [extremely anxiety provoking].
In fact, there is significant overlap between the measures correlations of. Factor analysis indicates that the items of the two scales are intermingled across factors. Some extreme, negative reactions have been termed sexual aversions. In the DSM—IV, sexual aversion is defined as persistent or recurrent extreme aversion to, and avoidance of, all or almost all, genital contact with a sexual partner. The behavioral reference of complete or almost complete absence of genital contact presumably signifies that all sexual activity is halted, and so the latter stages of the sexual response cycle would thus be circumvented.
Aside from specific genital avoidance, there may be wide variation in the clinical pattern of avoidance. From an assessment standpoint, aversion may be difficult to distinguish from anxiety with avoidance. At present, there are no experimental or clinical studies that have made the comparison. Thirty items are rated on a 4—point Likert scale and assess sexual fears associated with sexually transmitted diseases primarily HIV , sexual guilt, negative social evaluation, pregnancy, and sexual trauma.
Factor analyses suggest that the measure includes two domains that are potentially relevant to negative emotions disruptive of sexual excitement: Reliability data include estimates of. Few validity data are provided, but they are supportive in that the measure correlates. In contrast, the SAS assesses self-reported avoidance of sexual activities and negative emotionality about sex, including worry, self-consciousness, and self-criticism. Although the former factor sexual avoidance may be related to sexual aversion as defined by DSM—III—R, it is not clear whether the latter factor which appears to assess sexual neuroticism is.
Masters and Johnson proposed that orgasm is a reflex-like response that occurs once a plateau of excitement has been reached or exceeded, although the specific neurophysiologic mechanisms are not known.
The physiologic and behavioral indices of orgasm involve the whole body—facial grimaces, generalized myotonia of the muscles, carpopedal spasms, and contractions of the gluteal and abdominal muscles. For women, orgasm is also marked by rhythmic contractions of the uterus, the vaginal barrel, and the rectal sphincter, beginning at 0.
The subjective experience of orgasm includes feelings of intense pleasure with a peaking and rapid, exhilarating release. Women are unique in their capability to be multiorgasmic; that is, women are capable of a series of distinguishable orgasmic responses without a lowering of excitement between them.
There are few assessment measures of orgasm. In fact, in the majority of research e. There are unpublished measures e. The latter scale by Loos, Bridges, and Critelli assesses internal versus external and stable versus unstable attributions for regularity of orgasm during coitus.
There are few supporting psychometric data, although the initial report for the measure suggests that it can discriminate between women of high and low orgasm consistency. In our research, we have assessed awareness of the physiological signs and symptoms of orgasm e. We have found, for example, that women with and without orgasmic dysfunction differ on their awareness of orgasm signs see Figure 1.
These data replicate earlier research by Hoon and Hoon with a nondysfunctional sample. Their data indicated that women reporting the lowest orgasm consistencies were significantly less aware of physiological changes accompanying sexual arousal than women reporting higher consistencies of orgasm.
Percentage of orgasmic and orgasmic dysfunction individuals reporting the occurrence of orgasm signs. The lack of reliable and valid assessment methods for female orgasm may have contributed to the lack of clarity, heterogeneity, and controversy surrounding the criteria for female orgasmic dysfuntion Morokoff, ; Wakefield, In the current DSM definition of female orgasmic disorder in DSM—III—R, the label was inhibited female orgasm , it is defined as delayed or absent orgasm following an unimpaired sexual excitement phase.
No subtypes are noted, although requiring that the excitement phase be unimpaired imposes a de facto subgroup. Historically, other distinctions have been made. For example, primary orgasmic dysfunction has been the designation for women who have never experienced orgasm under any circumstances the possible exception might be an occasional orgasm during sleep with erotic dreams. A second clinical pattern, called secondary orgasmic dysfunction, has been used for women who have orgasms but express concern with their frequency or circumstances of occurrence e.
For many women, this represents normal variation in sexual response patterns and is usually not appropriate as a diagnostic entity. Other clinical scenarios e.
When this does occur, a history may reveal pharmacologic agents as instrumental; for example, anorgasmia in previously responsive women may be associated with the use of tricyclic antidepressants, monoamine oxidase inhibitors, benzodiazepines, and neuroleptics. Thus, too, etiological hypotheses for inorgasmia have emphasized the role of anxiety or other distressing affects Derogatis, et al.
Hypotheses for coitally inorgasmic women often focus on the role of the interpersonal couple relationship e. Thus, contrary to the current DSM criteria, theoretical and intervention research suggests that subtypes of orgasmic dysfuntion may exist. If the response cycle conceptualization is considered, previous phases—desire and excitement—would both be expected to have linkages to the occurance of orgasm.
For illustration, consider clinical cases of orgasmic dysfunction in which desire may or may not be regularly present, and excitement may or may not be regularly present see Table 3. The consideration of the desire and excitement phases in the context of a presenting complaint of orgasmic dysfunction leads to the delineation of phasic-based subtypes, in this case, subtypes for orgasmic dysfunction.
Hence, subtyping for assessment purposes is tied directly to the response cycle conceptualization. To examine this conceptualization empirically, we inspected the range of sexual arousability and sexual anxiety scores unfortunately, we did not collect data on desire of women who presented for a treatment outcome study for primary orgasmic dysfunction Andersen, When selecting women for study, we screened in for orgasmic dysfunction and screened out for dyspareunia, vaginismus, or medical problems.
These data suggest that the numbers of nonorgasmic women who would report unimpaired sexual arousal i. Furthermore, consideration of the relationship between orgasm and previous response cycle phases may provide useful assessment information for diagnostic and treatment purposes.
In summary, it is probable that there are diagnostically distinct subgroups of women who have difficulty with orgasm. The concluding phase of the sexual response is resolution. After orgasm, the anatomic and physiologic changes of excitement reverse. In women, the orgasmic platform disappears as vasocongestion diminishes, the uterus moves back into the true pelvis, and the vagina shortens and narrows.
A filmy sheet of perspiration covers the body and the elevated heart rate and respiration gradually return to normal. If orgasm has occurred, there are concomitant psychological sensations of bodily relaxation and feelings of release and sexual contentment—and satisfaction. If orgasm has not occurred, the same physiologic processes occur at a much slower rate, and the psychologic responses are usually either neutral or negative e.
Bentler, personal communication, October 4, For example, on the DSFI, there is a item sexual satisfaction scale. Each item appears to assess a different aspect of satisfaction with the sexual life, including satisfaction with the frequency and range of sexual activities, communication with partner, the occurrence of orgasm, and resolution feelings.
There are few psychometric data, but the available information is supportive. The internal consistency is. Validity data indicate that the measure appears to assess relevant aspects of depression, as it is correlated.
In contrast, it is not correlated —. In the past 20 years, reliability and validity data have accumulated for this measure; however, we note that the measure would be limited in the assessment of female sexuality per se. With two major exceptions Freud and Eysenk , few researchers have explored the relationship between personality and sexuality. However, in the past decade there has been a resurgance of research in personality. Here we discuss the relationship between sexual behavior and the response domains and the contemporary general model of personality structure—the Big Five model—and sexually relevant personality factors, such as sexual self-schema.
Historically, sexuality occupied a central role in psychology. Freud hypothesized that sexual instincts were the driving force in personality development, and sexual impulses gone awry were the etiological bases for psychopathology. Even later, neoanalysts and object relations theorists focused on the interrelationship between the capacity for sensuality and the development of stable, intimate relationships Fairburn, ; Klein, In the s Eysenck Eysenck , using his three-factor P-E-N model of personality, consisting of psychoticism, extraversion, and neuroticism, showed that personality and sexual variables were correlated.
For example, women scoring high on neuroticism had lower reported levels of sexual experience, whereas those high on extraversion particularly men had much higher levels of sexual experience. These findings suggested that the negative emotionality characteristic of neuroticism i.
Also, women scoring high on psychoticism reported greater involvement with coital and oral activities. They reported data from women seeking outpatient treatment for sexual problems. Women seeking treatment for sexual dysfunction and scoring high on neuroticism particularly subscales endorsing higher anxiety or depression and self-consciousness reported lower levels of sexual information —.
Conversely, women scoring higher on openness individuals who seek out and appreciate varied experiences reported higher levels of sexual information. No significant correlations were found with the other personality scales i.
Measures of sexual attitudes, affects, behaviors, and more recently, cognitions, are available. Several individual difference measures assess evaluative attitudinal or affective reactions to sexual cues. According to this view, erotophobic individuals have negative affective and evaluative responses to sex and should therefore show avoidance, whereas erotophilic individuals, who have a positive affective and evaluative response to sex, should evidence approach responses.
Factor analysis of the 21 items indicate that three dimensions are assessed: Validity research indicates that, as expected, there is a positive correlation between erotophilia scores and measures of sexual behavior intercourse and sexual fantasy. This scale assesses four attitude topics: Simpson and Gangestad a , b have offered a conceptual framework for their focus on sociosexual orientation or the willingness to engage in uncommitted sexual relations. Individuals who possess an unrestricted sociosexual orientation require less closeness and commitment before having sex, whereas a restricted sociosexual orientation requires greater emotional involvement.
Validity information indicates, for example, that unrestricted individuals tend to engage in sex at an earlier point in their sexual relationships; are more apt to have concurrent sexual affairs; and have relationships characterized by less commitment, love, and psychological dependency.
Surprisingly, there has been little attention to cognitive representations of sexuality i. From this perspective, cognitions about the self e. We have proposed that sexual self-schema self-concept is a cognitive view about sexual aspects of oneself. In addition to regulating intrapersonal processes, sexual self-schema mediates interpersonal processes, the most obvious being sexual relationships. Individuals with a clearly specified, positive sexual schema, for example, enter sexual relationships more willingly, have a more extensive behavioral repertoire, and evidence more positive emotions when in sexual relationships.
Women with a positive sexual schema, relative to those with a negative schema, view themselves as emotionally romantic or passionate, and as behaviorally open to romantic and sexual relationships and experiences. These women tend to be liberal in their sexual attitudes, and are generally free of such social inhibitions as self-consciousness or embarrassment.
Women with positive schemas for example, tend to evaluate various sexual behaviors more positively, report higher levels of arousability across sexual experiences, and are more willing to engage in uncommitted sexual relations. This schematic representation is not merely a summary statement of sexual history, but it marks current and future possibilities, as women with positive schemas anticipate more sexual partners in the future than their counterparts with negative schemas.
Despite this seemingly unrestricted view of sexuality, it is perhaps important to note that affects and behaviors indicative of romantic, loving, and intimate attachments are also central to women with positive sexual schemas, as they report extensive histories of romantic ties.
Thus, the positive schematic representation of a sexual woman includes both arousal—drive and romantic—attachment elements. Conversely, women holding clear negative self-views of their sexuality tend to describe themselves as emotionally cold or unromantic and as behaviorally inhibited in their sexual and romantic relationships.
These women tend to espouse conservative and, at times, negative attitudes and values about sexual matters and may describe themselves as self-conscious, embarrassed, or not confident in a variety of social and sexual contexts. Finally, there may be some potential vulnerability for women with negative self-views because their self-view can be significantly moderated or defined by others e.
In addition to representing positive and negative sexual schemas, the Sexual Self-Schema Scale can be scored to represent aschematic and coschematic profiles.
Women who are aschematic appear to lack a coherent framework for guiding sexually relevant perceptions, cognitions, and behaviors.
On the schema measure, they provide weak endorsements of both positive and negative schema adjectives. Hypotheses that such women have lower rates of sexual behavior and less positive sexual affects e. Our hypothesis that coschematic women might evidence discrepancies in their sexual affects has been confirmed; these women report higher levels of sexual anxiety, yet high levels of romantic attachment love for a partner.
A final methodologic note about the scale is that the measure consists of 26 trait adjectives, and respondents completing the measure have no notion that an aspect of sexuality is being assessed. This aspect of the measure contrasts markedly with every assessment scale reviewed here, and it thus offers significant methodologic and clinical advantages. Measures of current sexual behavior e. For the present analyses, we averaged the current sexual behavior variables to obtain a more stable estimate.
The data are provided in Table 4. Considering the five personality dimensions, the most consistent pattern of relationships was found for the Extraversion scale. This pattern is inconsistent with the pattern that Costa et al.
One interpretation of these differences is that they indicate important generational and developmental differences in the study samples. Among older, predominately married women whose patterns of sexual behavior and responding may be more established, the dimension of neuroticism appears to be a more important personality variable. Comparison of the Big Five data with the sexual-specific measures reveals the usefulness of using such measures to predict sexual variables.
As might be anticipated, the sociosexuality measure correlated strongly with measures of sexual behavior, and these data suggest potential overlap with measures assessing sexual history, particularly the number of previous partners.
For the erotophobia measure, these data suggest that the construct functions as a generalized deterrent for sexual behavior as well as positive sexual responses. Finally, the sexual schema measure, as would be predicted, is correlated to virtually all aspects of sexuality. We propose that the assessment of female sexuality be considered within the conceptual domains of sexual behaviors, sexual responses, and individual differences rather than by categories e.
Self-reports of sexual behavior have proven a necessary mainstay in both historical and contemporary assessments of female sexuality.
However, many methodological problems of such assessments remain see Catania et al. Still, sufficient research has emerged to suggest that the behavioral domain for women includes the behaviors of masturbation and other individual erotic activities, and arousing activities with a heterosexual partner ranging from kissing, erotic caressing, oral-genital contact, and anal stimulation, to intercourse.
A response cycle conceptualization, a four-stage model consisting of sexual desire, excitement, orgasm, and resolution, offers conceptual and diagnostic advantages. Within this framework, we considered physiological, cognitive, and affective assessment approaches. One area in need of scientific advancement is the concept of sexual desire but see Beck, I am good looking, sane, smart and sexywith no drama, baggage. You will not be disappointed.
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