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The high burden of exposure to chronic life adversities and trauma is quite prevalent, but assessment of this risk burden is uncommon in primary care settings. This calls for a brief, multiple dimensional mental health risk screening tool in primary care settings. We aimed to develop such a screening tool named the University of California, Los Angeles (UCLA) Life Adversities Screener (LADS). Using pooled data across 4 studies from the UCLA Center for Culture, Trauma, and Mental Health Disparities, 5 domains of mental health risk including perceived discrimination, sexual abuse histories, family adversity, intimate partner violence, and trauma histories, were identified. Regression models for depression (Centers for Epidemiology Studies Depression Scale) and posttraumatic stress disorder (Posttraumatic Diagnostic Scale), controlling for demographic factors, were fitted to develop a weighted continuous scale score for the UCLA LADS. Confirmatory factor analysis supported the 5-domain structure, while item response theory endorsed the inclusion of each item. Receiver operating characteristic analysis indicated that the score was predictive for classifying subjects as reaching clinical threshold criteria for either depression (Beck Depression Inventory-II ≥ 14 or Patient Health Questionnaire-9 ≥ 10) or anxiety (Patient Health Questionnaire-13 ≥10). An optimal cut of 0.33 is suggested based on maximizing sensitivity and specificity of the LADS score, identifying patients at high risk for mental health problems. Given its predictive utility and ease of administration, the UCLA LADS could be useful as a screener to identify racial minority individuals in primary care settings who have a high trauma burden, needing more extensive evaluation., ((c) 2015 APA, all rights reserved.)

"Excessive" viewing of visual sexual stimuli (VSS) is the most commonly reported hypersexual behavior problem and is especially amenable to laboratory study. A pattern of enhanced sexual cue responsiveness is expected in this sample if hypersexuality shares features of other addiction models. Participants (N=122) who either reported or denied problematic VSS use were presented with emotional, including explicit sexual, images while their evoked response potentials were recorded. An interaction of hypersexual problem group and the level of desire for sex with a partner predicted LPP amplitude. Specifically, those reporting problems regulating their VSS use who also reported higher sexual desire had lower LPP in response to VSS. This pattern appears different from substance addiction models. These are the first functional physiological data of persons reporting VSS regulation problems., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Introduction: Time spent viewing visual sexual stimuli (VSS) has the potential to habituate the sexual response and generalize to the partner context., Aim: The aim of this study was to examine whether the time spent viewing VSS is related to sexual responsiveness felt in the laboratory or with a sexual partner., Methods: Nontreatment-seeking men (N = 280) reported their weekly average VSS viewing in hours. VSS hours were examined in relation to the sexual arousal experienced while viewing a standardized sexual film in the laboratory and erectile problems experienced with a sexual partner., Main Outcome Measures: Self-reported sexual arousal in response to sexual films and erectile problems on the International Index of Erectile Function were the main outcome measures., Results: More hours viewing VSS was related to stronger experienced sexual responses to VSS in the laboratory, was unrelated to erectile functioning with a partner, and was related to stronger desire for sex with a partner., Conclusions: VSS use within the range of hours tested is unlikely to negatively impact sexual functioning, given that responses actually were stronger in those who viewed more VSS.

This study examined the utility of a lifetime cumulative adversities and trauma model in predicting the severity of mental health symptoms of depression, anxiety, and posttraumatic stress disorder. We also tested whether ethnicity and gender moderate the effects of this stress exposure construct on mental health using multigroup structural equation modeling. A sample of 500 low-socioeconomic status African American and Latino men and women with histories of adversities and trauma were recruited and assessed with a standard battery of self-report measures of stress and mental health. Multiple-group structural equation models indicated good overall model fit. As hypothesized, experiences of discrimination, childhood family adversities, childhood sexual abuse, other childhood trauma, and chronic stresses all loaded on the latent cumulative burden of adversities and trauma construct (CBAT). The CBAT stress exposure index in turn predicted the mental health status latent variable. Although there were several significant univariate ethnic and gender differences, and ethnic and gender differences were observed on several paths, there were no significant ethnic differences in the final model fit of the data. These findings highlight the deleterious consequences of cumulative stress and trauma for mental health and underscore a need to assess these constructs in selecting appropriate clinical interventions for reducing mental health disparities and improving human health., ((c) 2015 APA, all rights reserved).)

A person's ability to control their own sexual arousal is important both to reduce the risks associated with some sexual behaviours and to respond sexually with intimate partners. A lack of control over sexual urges is a proposed feature of "hypersexual disorder", though some evidence suggests that sexual desire predicts the self-regulation of sexual arousal better than hypersexuality. In the current study, a sample (N = 116) of men and women recruited from community ads viewed a series of 20-second neutral and sexual films. Before each sexual film, participants were instructed to increase their sexual arousal, decrease their sexual arousal or respond as usual. Higher levels of desire for sex with a partner consistently predicted failures to downregulate sexual arousal. Hypersexuality was unrelated. These findings replicate Winters et al.'s study and extend their findings by including upregulation, women, a new measure of hypersexuality and a higher-trial design.

Risky sexual behaviors typically occur when a person is sexually motivated by potent, sexual reward cues. Yet, individual differences in sensitivity to sexual cues have not been examined with respect to sexual risk behaviors. A greater responsiveness to sexual cues might provide greater motivation for a person to act sexually; a lower responsiveness to sexual cues might lead a person to seek more intense, novel, possibly risky, sexual acts. In this study, event-related potentials were recorded in 64 men and women while they viewed a series of emotional, including explicit sexual, photographs. The motivational salience of the sexual cues was varied by including more and less explicit sexual images. Indeed, the more explicit sexual stimuli resulted in enhanced late positive potentials (LPP) relative to the less explicit sexual images. Participants with fewer sexual intercourse partners in the last year had reduced LPP amplitude to the less explicit sexual images than the more explicit sexual images, whereas participants with more partners responded similarly to the more and less explicit sexual images. This pattern of results is consistent with a greater responsivity model. Those who engage in more sexual behaviors consistent with risk are also more responsive to less explicit sexual cues., (© The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.)

Aims: In the last 5 years a deluge of articles on the topic of Internet addiction (IA) has proposed many candidate symptoms as evidence of this proposed disease. We critically reviewed the current approach to the measurement and identification of this new excessive behavior syndrome., Methods: Three popular models of IA were discussed: Griffith’s components model; Young’s Internet Addiction Test (IAT); and the criteria by Tao et al. (2010). We selected these models because they are widely cited and propose specific criteria for IA disorder. Our approach is not meant to provide an exhaustive review, but to discuss and critique the most salient trends in the field., Results: The models of Internet addiction share some criteria, including feeling a loss of control over Internet use; ensuing psychological, social, or professional conflict or problems; and preoccupation when not using the Internet. Other criteria inconsistently mentioned include: mood management, tolerance, withdrawal, and craving/anticipation. The models studied here share the assumption that the Internet can produce a qualitative shift to a diseased state in humans., Conclusions: We critically discussed the above criteria and concluded that the evidence base is currently not strong enough to provide support for an Internet addiction disorder. Future research areas are suggested: (1) Focusing on common impaired dimensions, (2) exploring neuroimaging as a model building tool, and (3) identifying shifts in the rewarding aspects of Internet use. Given the lack of consensus on the subject of Internet addiction, a focus on problem behaviors appears warranted.

Visual sexual stimuli can motivate sexual behaviors that can risk or enhance health. How one allocates attention to a sexually motivating stimulus may be important for predicting its effect on sexual feelings, sexual risk behaviors, and sexual problems. A large sample (N = 157) of men and women rated the similarity of all possible pairs of photographs of women, which had been pretested to vary in their sexual and affective content. Multidimensional scaling was used to extract two dimensions of sex and affect, including the extent to which each person relied on each dimension in making their similarity judgments. These individual weights were then used to predict sexual variables of interest. Participants who relied more on the affect information judging photograph similarity were more likely to be female, viewed erotica less frequently, reported fewer sexual partners, reported less sexual desire, and more sexual problems. Those who relied more on the erotic content in making their similarity judgments were more likely to be male, viewed more erotica weekly, experienced higher sexual desire, and were more likely to have taken an HIV test. The "double edge sword" of attention weight to affect in sexual cues is discussed for its potential to both enhance and harm sexual health.

Anterior alpha asymmetry of electroencephalographic (EEG) signals has been suggested to index state approach (or avoidance) motivation. This model has not yet been extended to high approach-motivation sexual stimuli, which may represent an important model of reward system function. Sixty-five participants viewed a neutral and a sexually motivating film while their EEG was recorded, and reported their sexual feelings after each film. Greater alpha power in the left hemisphere during sexually motivated states was evident. A positive relationship between self-reported mental sexual arousal and alpha asymmetry was identified, where coherence between these indicators was higher in women. Notably, coherence was stronger when mental versus physical sexual arousal was rated. Alpha asymmetry appears to offer a new method for further examining this novel coherence pattern across men and women., (Copyright © 2014 Society for Psychophysiological Research.)

Introduction: Women are often reported to have a low coherence (often referred to as "discordance" in sexuality literature) between their genital response and self-reported sexual arousal., Aim: The purpose of this study was to determine whether differing instructions for rating sexual arousal would increase the coherence between genital response and self-reported arousal in women., Methods: Genital responses were recorded, using vaginal photoplethysmography, from 32 young women while they fantasized in three different conditions. Conditions instructed women to rate their overall sexual arousal, any physical cues, and genital blood flow., Main Outcome Measures: The primary outcome measure was the coherence of vaginal pulse amplitude (VPA) and reported sexual response in the three conditions., Results: Unexpectedly, both VPA response and self-reported sexual arousal were higher when women were asked to rate their genital blood flow. Examining only participants who reported at least some sexual arousal in all conditions (n = 17), coherence was highest when women were instructed to rate overall sexual arousal., Conclusion: Results suggest that focusing on genital blood flow during sexual fantasy may increase women's (self-reported and genital) sexual response. Focusing on any physical arousal cues during sexual fantasy was associated with lower coherence of women's genital response and self-reported arousal compared with when they were instructed to rate their overall sexual arousal., (© 2013 International Society for Sexual Medicine.)

Background: Modulation of sexual desires is, in some cases, necessary to avoid inappropriate or illegal sexual behavior (downregulation of sexual desire) or to engage with a romantic partner (upregulation of sexual desire). Some have suggested that those who have difficulty downregulating their sexual desires be diagnosed as having a sexual 'addiction'. This diagnosis is thought to be associated with sexual urges that feel out of control, high-frequency sexual behavior, consequences due to those behaviors, and poor ability to reduce those behaviors. However, such symptoms also may be better understood as a non-pathological variation of high sexual desire. Hypersexuals are thought to be relatively sexual reward sensitized, but also to have high exposure to visual sexual stimuli. Thus, the direction of neural responsivity to sexual stimuli expected was unclear. If these individuals exhibit habituation, their P300 amplitude to sexual stimuli should be diminished; if they merely have high sexual desire, their P300 amplitude to sexual stimuli should be increased. Neural responsivity to sexual stimuli in a sample of hypersexuals could differentiate these two competing explanations of symptoms., Methods: Fifty-two (13 female) individuals who self-identified as having problems regulating their viewing of visual sexual stimuli viewed emotional (pleasant sexual, pleasant-non-sexual, neutral, and unpleasant) photographs while electroencephalography was collected., Results: Larger P300 amplitude differences to pleasant sexual stimuli, relative to neutral stimuli, was negatively related to measures of sexual desire, but not related to measures of hypersexuality., Conclusion: Implications for understanding hypersexuality as high desire, rather than disordered, are discussed.

Viewing visual sexual stimuli (VSS) has been documented to have both positive (e.g., increased sexual arousal and sexual behaviors) and negative (e.g., higher anxiety, devaluing of partner attractiveness) effects. Excitation transfer and social comparison theories were used to generate hypotheses that could explain these mixed findings. Forty-four monogamous, heterosexual couples viewed erotic, exciting (non-erotic films), and nature films both alone and together. They rated their feelings of general arousal and relationship satisfaction as well as perceptions of self and partner sexual behaviors and attractiveness. Participants viewing both the erotic and exciting films reported equivalent increases in excitement; however, the erotic film was rated as slightly more generally arousing and increased participant's desire to be close to their partner. Viewing the erotic films also induced greater reports of negative affect, guilt, and anxiety. These findings moderately support a transfer of excitation interpretation. No effects of partner presence or absence while viewing the films was found. Viewing erotic films led to more positive evaluations of one's own sexual behaviors. These findings provide mixed support in regard to self and partner social comparisons. Co-occurring positive and negative emotional reactions were explored as possible explanation to the complex reactions to VSS.

Distractions from sexual cues have been shown to decrease the sexual response, but it is unclear how distracters decrease sexual response. Individual differences may modulate the efficacy of distracters. Forty women viewed three sexual films while their labial temperature and continuous self-reported sexual arousal were monitored. One sexual film had simultaneous verbal distracters concerning dissatisfaction with one's physical appearance (higher salience distracter), a second had distracters concerning daily chores (lower salience distracter), and the third sexual film had no distracters. Participant's reporting greater relationship satisfaction and more communication with their partner about their own physical appearance were expected to decrease the efficacy (increased sexual arousal) of the distracters concerning physical appearance. Contrary to expectations, women who received less feedback about their body from their partners reported less sexual arousal during a sexual film with body distracters than a sexual film with general distracters or a sexual film with no distracters. All women exhibited lower labial temperature in Minutes 2 and 3 of the sexual film with body image distracters as compared to the other two sexual films. Possible explanations explored include self-verification theory and individual differences in the indicators that women consider when rating their sexual arousal.

Two theories of sexual risk taking (disinhibition and alcohol myopia) were tested using genital measures of sexual response and computer measures of sexual risk propensity. A total of 44 men and women completed two sessions comparing responses to erotic films while consuming alcohol (breath alcohol doses were .025 g/kg and .08 g/kg) or juice alone. After consuming alcohol, more sexual arousal was reported in response to neutral films and at a breath alcohol level of .08 g/kg as compared to no alcohol. Genital responses for men and women increased during sexual films, but men did not respond as strongly when breath alcohol level was .08 g/kg. Intentions to have intercourse with a new partner at baseline predicted the level of sexual arousal reported. As self-reported sexual arousal increased in response to sexual films and higher alcohol dose, the intent to engage in intercourse with a new partner increased. Alcohol dose was not related to later sexual intercourse intentions. With no direct relationship of alcohol and intercourse intentions, results appear more consistent with a disinhibition model of sexual arousal.

Purpose: To prospectively assess the intestinal symptoms and fecal continence in patients who had undergone conformal radiotherapy (CRT) for prostate cancer., Methods and Materials: A total of 78 men who had undergone definitive CRT for prostate cancer were evaluated. The patients were assessed before, during (treatment Weeks 4 and 6), and 2, 12, and 24 months after CRT completion. The intestinal symptoms and fecal continence were evaluated with comprehensive standardized questionnaires., Results: The intestinal symptoms were mostly intermittent, with only a small minority of patients affected daily. Defecation pain, fecal urge, and rectal mucous discharge increased significantly during therapy. Defecation pain and rectal mucous discharge had returned to baseline levels within 8 weeks and 1 year after CRT, respectively. However, fecal urge remained significantly elevated for ≤1 year and then returned toward the pretreatment values. The prevalence of rectal bleeding was significantly elevated 2 years after CRT. Fecal continence deteriorated during CRT and remained impaired at 1 year after treatment. Incontinence was mostly minor, occurring less than once per week and predominantly affecting incontinence for gas., Conclusion: Intestinal symptoms and fecal incontinence increased during prostate CRT. Except for rectal bleeding, the intestinal symptoms, including fecal incontinence, returned to baseline levels within 1-2 years after CRT. Thus, the rate of long-term late radiation-related intestinal toxicity was low., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Vaginal pulse amplitude (VPA) has been the most commonly analyzed signal of the vaginal photoplethysmograph. Frequent, large, and variable-morphology artifacts typically have crowded this signal. These artifacts usually were corrected by hand, which may have introduced large differences in outcomes across laboratories. VPA signals were collected from 22 women who viewed a neutral film and a sexual film. An automated, wavelet-based, denoising algorithm was compared against the uncorrected signal and the signal corrected in the typical manner (by hand). The automated wavelet denoising resulted in the same pattern of results as the hand-corrected signal. The wavelet procedure automated artifact reduction in the VPA, and this mathematical instantiation permits the comparison of competing methods to improve signal:noise in the future.

Introduction: Sexual desire variation traditionally has been treated as due to variance in affective response to sexual stimulation, but differences in attention to the stimuli may better account for differences in sexual desire., Aim: Determine whether sexual desire varies due to attention biases towards sexual stimuli., Main Outcome Measures: Sexual arousal was quantified by physiological (labia minus temperature) and experienced (continuously adjusting a potentiometer) indicators., Methods: Twenty-two women who varied in their level of sexual desire attended one laboratory session during which they viewed a neutral nature film, a sexual film, and a sexual film with distractors while their labial temperature and self-reported sexual arousal were recorded., Results: Participants reported and displayed lower sexual arousal during the sexual stimulus with distractors as compared to the sexual film without distractors. While all women reported lower sexual arousal to the sexual film with distractors, women with relatively lower sexual desire also reported lower sexual arousal to the sexual film with no distractors than women with higher sexual desire. Physiologically, women with lower sexual desire exhibited lower labial temperature., Conclusions: Since the predicted lower self-reported and physiological sexual arousal to the sexual stimulus with distractors for the women with lower sexual desire did not emerge, this study does not support that sexual desire levels vary due to differential attention to sexual stimuli.

Purpose: To prospectively assess quality of life (QoL) in patients receiving conformal radiation therapy (CRT) for prostate cancer., Patients and Methods: 78 men with definitive CRT for prostate cancer were entered into the study. Patients were assessed before CRT, at 40 and 60 Gy, and 2, 12 and 24 months after the end of treatment. QoL was assessed using the EORTC Quality of Life Questionnaire C30 and the prostate module PR25. Changes in mean QoL scores with time of >or= 10 points were considered clinically relevant., Results: Global QoL did not change statistically significant during CRT and was slightly above baseline levels during follow-up. CRT had a statistically significant negative short-term impact on role functioning, fatigue, and PR25 urinary symptoms. The scores recovered within 2 months to 1 year after CRT. Emotional functioning and social functioning scores slightly increased during and after CRT. Role functioning decreased by > 10 points at 60 Gy and urinary symptoms decreased by > 10 points at 40 and 60 Gy. All other differences were < 10 points. A high number of concomitant diseases and having no children were negative pretreatment predictors for long-term global QoL., Conclusion: Definitive CRT for prostate cancer does not compromise global QoL during therapy and up to 2 years after treatment. It has a limited negative effect on role functioning, urinary symptoms and, to a lesser extent, on fatigue with restitution within 2 months to 1 year after treatment.

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.

The term "asexual" has been defined in many different ways and asexuality has received very little research attention. In a small qualitative study (N = 4), individuals who self-identified as asexual were interviewed to help formulate hypotheses for a larger study. The second larger study was an online survey drawn from a convenience sample designed to better characterize asexuality and to test predictors of asexual identity. A convenience sample of 1,146 individuals (N = 41 self-identified asexual) completed online questionnaires assessing sexual history, sexual inhibition and excitation, sexual desire, and an open-response questionnaire concerning asexual identity. Asexuals reported significantly less desire for sex with a partner, lower sexual arousability, and lower sexual excitation but did not differ consistently from non-asexuals in their sexual inhibition scores or their desire to masturbate. Content analyses supported the idea that low sexual desire is the primary feature predicting asexual identity.

Aim: The labial photoplethysmograph (LP), a new measure for assessing genital responses in women, was compared to the vaginal photoplethysmograph (VP)., Methods: Fifteen women wore both devices simultaneously while viewing neutral, sexual, sexually-threatening, and threatening film clips., Results: The LP and VP exhibited comparable specificity to sexual stimuli. Additionally, the LP demonstrated greater resistance to movement artifacts and a slightly higher correspondence with subjective measures of sexual arousal., Conclusion: The LP, while somewhat more difficult to place and less comfortable than the VP, is a promising new measure of genital response in women that warrants further development.