Search

Objective: To investigate the associations between sexual health dimensions, and overall health and well-being., Methods: In February 2024, we systematically searched Scopus, PsyArticles, PsycINFO®, PubMed®, Web of Science and LILACS for articles reporting on associations between sexual health, health and well-being indicators. We applied no language restrictions and followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. To assess the risk of bias in the included studies, we used the Risk Of Bias In Non-randomized Studies - of Exposures tool., Findings: Of 23 930 unique titles identified, 63 studies met the inclusion criteria. We grouped the results into two categories: (i) sexual and physical health; and (ii) sexual and psychological health. The results consistently showed strong correlations between sexual health, overall health and well-being. Almost all studies found significant associations between positive sexual health indicators and lower depression and anxiety, higher quality of life, and greater life satisfaction among men and women, including older adults, pregnant women, and same-sex and mixed-sex couples., Conclusion: Findings indicate that emphasizing a positive perspective on sexual health and highlighting its benefits should be regarded as an important component of the effort to improve overall health and well-being for everyone., ((c) 2024 The authors; licensee World Health Organization.)

Background: Psychological difficulties, including depression, anxiety, and somatization, are among the most important predictors for women's sexual function (i.e., arousal, desire, lubrication, pain, and satisfaction) and sexual distress. These associations have largely been studied at the construct level, with little research examining which specific symptoms might be most important for maintaining links between psychological difficulties and domains of sexual function. The present research sought to establish and characterize networks of women's psychological symptoms, sexual function, and sexual distress, and identify potential bridge symptoms that connect them., Methods: In a cross-sectional study, 725 women reported on their sexual function, sexual distress, and depressive, anxiety, and somatization symptoms. A series of network analyses was used to identify central symptoms and connections between psychological symptoms, sexual function domains, and sexual distress., Results: Across the modeled networks, sexual distress and pain during sex were consistent bridges between other sexual function domains and psychological symptoms., Discussion: Overall, our models revealed sexual distress as an important potential mediator between sexual function problems and psychological symptoms that might contribute to the development and maintenance of comorbid sexual function and psychological problems., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Introduction: Sexual distress related to sexual function (SDRSF) is pivotal in diagnosing sexual dysfunction. However, there is a lack of theoretical models for its comprehension and of knowledge concerning how to address it in clinical practice., Aim: To contribute to theory building and clinical practice about SDRSF by collecting clinicians' accounts, aiming to inform a preliminary framework to study and intervene in SDRSF., Method: Reflexive thematic analysis was used to analyze the data from 16 semi-structured interviews with clinical sexologists. Results: Three main themes were created: (1) Burning from the inside, (2) Wicked games, and (3) Running up that hill. Participants revealed a multidimensional understanding of SDRSF in clinical settings that integrates individual, sociocultural, interpersonal and situational factors. This underscores the interconnected nature of SDRSF, revealing its links to different facets of overall distress in clinical settings. We present a preliminary framework that may be analytically generalized to enhance the comprehension of the specificities of SDRSF., Conclusion: These insights frame a comprehensive conceptualization of SDRSF in clinical settings that goes beyond sexual activity and implies that interpersonal and societal factors need to be considered in research and intervention in this field., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier B.V.)

Background: Given the unprecedented aging of the population and the increased focus on overall well-being in older age, investigating the determining factors of sexual well-being in older adults becomes essential as it offers insights into promoting healthy aging and overall quality of life., Aim: By applying the biopsychosocial model of sexuality in older age, we aimed to identify the role of biomedical and psychosocial factors in predicting sexual well-being in partnered older adults (≥55 years old)., Methods: A total of 111 participants (mean [SD], 63.2 [5.96]) completed a self-report questionnaire assessing biopsychosocial dimensions. Bivariate correlational analyses and hierarchical multiple regression were conducted to investigate factors associated with sexual well-being. Health-related factors were entered into the first regression model. The second model included factors pertaining to relationship dimensions. Sexual beliefs were introduced in the third regression model., Outcomes: Self-rated health, psychological distress, subjective cognitive decline, sexual beliefs, duration of the relationship, relationship satisfaction, and sexual well-being were assessed., Results: Findings from the hierarchical regression revealed that duration of relationship [t(104) = -3.07, P < .01], relationship satisfaction [t(104) = 8.49, P < .001], and age-related sexual beliefs [t(104) = -2.75, P < .01] were significant predictors of sexual well-being of partnered older adults [F(6, 104) = 22.77, P < .001, R2 = .57], after controlling for health-related factors. These findings suggest that relationship factors and sexual beliefs play a significant role in predicting sexual well-being of older adults, above and beyond health-related dimensions., Clinical Implications: Interventional approaches aimed at promoting sexual well-being in older age might benefit from incorporating exercises that demystify age-related sexual beliefs, by normalizing changes that occur with aging and fostering positive attitudes toward sexual expression in older age; particularly for older adults in long-term relationships, relationship satisfaction must also be considered as an important intervention target., Strengths and Limitations: Further investigation using longitudinal designs is required to examine the causal links between these factors and sexual well-being in older age., Conclusion: Findings from this study underscore the role of relationship dimensions and age-related sexual beliefs for the sexual well-being of partnered older adults., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Sexual health is an important component of quality of life in older adults. However, older adults often face barriers to attaining a fulfilling sexual life because of issues such as stigma, lack of information, or difficult access to adequate support., Objective: We aimed to evaluate the user experience of a self-guided, smartphone-delivered program to promote sexual health among older adults., Methods: The mobile app was made available to community-dwelling older adults in the Netherlands, who freely used the app for 8 weeks. User experience and its respective components were assessed using self-developed questionnaires, the System Usability Scale, and semistructured interviews. Quantitative and qualitative data were descriptively and thematically analyzed, respectively., Results: In total, 15 participants (mean age 71.7, SD 9.5 years) completed the trial. Participants showed a neutral to positive stance regarding the mobile app's usefulness and ease of use. Usability was assessed as "Ok/Fair." The participants felt confident about using the mobile app. To increase user experience, participants offered suggestions to improve content and interaction, including access to specialized sexual health services., Conclusions: The sexual health promotion program delivered through a smartphone in a self-guided mode was usable. Participants' perception is that improvements to user experience, namely in content and interaction, as well as connection to external services, will likely improve usefulness and acceptance., (©Ana Correia de Barros, Mariëtte Bergmans, Kreshnik Hasanaj, Drianë Krasniqi, Catarina Nóbrega, Bruna Carvalho Carneiro, Priscila A Vasconcelos, Ana Luísa Quinta-Gomes, Pedro J Nobre, Joana Couto da Silva, Cristina Mendes-Santos. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 03.04.2024.)

There is limited understanding of the dynamic between relational and sexual well-being as couples adjust to new parenthood, despite this being a vulnerable period for couples' relationships. This study was aimed at examining the bidirectional links between relationship quality and sexual well-being (i.e., sexual satisfaction, sexual distress) across the transition to parenthood. We assessed new parent couples (N = 257) across four time points (two prenatal) from mid-pregnancy through 6 months postpartum. Parallel dyadic latent growth curve modeling was employed to examine the associations between trajectories of perceived relationship quality, sexual satisfaction, and sexual distress. New parents' declines in relationship quality were associated with declines in own and partners' sexual satisfaction and with increases in own sexual distress. Mothers' prenatal relationship quality and sexual distress predicted subsequent changes in own sexual distress and fathers' relationship quality, respectively. Results indicate that changes to new parents' relational and sexual well-being mutually influence each other over time. Current results indicate that the impact of the transition on couples' relationships is partly determined by own and partners' prenatal factors, to which clinicians and researchers can attend to early on. Cross-domain links between relational and sexual well-being should be considered in research and clinical practice., (© 2023 The Authors. Family Process published by Wiley Periodicals LLC on behalf of Family Process Institute.)

Background: Colorectal cancer diagnosis and treatment negatively impact sexual health. However, there is still a lack of interventions targeting the sexual healthcare needs of colorectal cancer patients and survivors. This systematic review aimed to identify and summarize the efficacy of available psychological interventions aimed at improving colorectal cancer patients' and survivors' sexual health., Methods: This review followed PRISMA guidelines for systematic reviews. A database search was conducted for studies published until July 2023 on EBSCO Host, Web of Science, PubMed, and the Cochrane Library. Manuscripts were screened according to inclusion and exclusion criteria. The risk of bias was assessed using the Quality Assessment Tool for Quantitative Studies., Results: From the 1499 records screened, four studies describing psychological interventions to improve the sexual health of the target population were identified. All studies reported on e-health programs and showed evidence of their efficacy in the improvement of participants' sexual function. The studies presented low scores on the Quality Assessment Tool for Quantitative Studies., Conclusions: Despite the evidence that tele/e-health psychological interventions have the potential to effectively promote sexual health in colorectal cancer patients and survivors, more robust research is needed to allow for generalization. Future research should further assess the efficacy of e-health interventions (eMental Health) in promoting sexual health in patients with colorectal cancer.

The Sexual Self-Consciousness Scale (SSCS) is an instrument for assessing dispositional propensities for self-consciousness experienced in a sexual context, with wide application in both clinical and research settings. The objective of the current study was to test some psychometric characteristics of the Portuguese version of the SSCS using a convenience sample of 210 men and 210 women. Participants completed a sociodemographic questionnaire and the Portuguese version of the SSCS. A subsample of 87 participants was assessed at a second time point after a 2-week period for measuring test-retest reliability of the instrument. Confirmatory factor analysis identified two factors and replicated the structure of the original instrument. Measurement invariance was confirmed for men and women with overall index scores indicating a good fit in all models. Reliability analyses indicated that the factors possessed both satisfactory internal consistency and stability over time. The Portuguese version of the SSCS was shown to be a useful and adequate instrument to assess dispositional propensities for self-consciousness in sexual situations within the Portuguese-speaking population.

Introduction: Prostate cancer is the second-most prevalent cancer diagnosis worldwide among males. Although prostate cancer affects the physical, sexual, and mental health of patients, the impact of prostate cancer on partners has also been increasingly recognized. Hence, taking a dyadic approach is of relevance. Moreover, there is evidence of the utility of dyadic approaches to the study of relational stress that chronic diseases such as prostate cancer can bring to couples, even though knowledge is sparse about prostate cancer., Objectives: This scoping review aimed to map existing dyadic studies on the psychosocial adaptation of couples to prostate cancer., Methods: A systematic search of studies published from 2005 to November 2022 was conducted on electronic databases (PubMed, Cochrane Library, EBSCOHost, Scopus, and Web of Science) following PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses-Extension for Scoping Reviews)., Results: The review included 25 eligible studies from the initial 2514 articles retrieved. Overall, the results emphasized the interdependency between couple members and suggested how partners' adaptation influences patients' adaptation to prostate cancer and vice versa, regarding several psychosocial dimensions (eg, intimacy, quality of life)., Conclusions: This work can bring awareness to health care professionals to adopt a couples approach when managing prostate cancer whenever there is a partner, due to these interdependent influences. For researchers and future studies, this work can strengthen the relevance of dyadic approaches on how couples adapt to prostate cancer and explore which other dimensions influence these complex dynamics., (© The Author(s) 2023. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Sexual distress, a determinant factor in diagnosing sexual dysfunction, plays a significant role in individuals' sexual well-being, yet it has been overlooked in research., Aim: This exploratory study adopted a transdiagnostic approach to sexual distress and sought to examine the association between emotional regulation difficulties and sexual and psychological distress, with repetitive negative thinking as a potential mediator., Methods: We used a quantitative cross-sectional design with a sample of 509 partnered individuals., Outcomes: The survey included a sociodemographic questionnaire, the Difficulties in Emotion Regulation Scale-Short Form, the Kessler Psychological Distress Scale, the Persistent and Intrusive Negative Thoughts Scale, and the Female Sexual Distress Scale-Revised., Results: Correlational analysis revealed significant associations among emotional regulation difficulties, repetitive negative thinking, psychological distress, and sexual distress. Furthermore, a mediation model demonstrated that repetitive negative thinking significantly mediated emotion dysregulation and psychological and sexual distress., Clinical Implications: These findings underscore the importance of considering emotion regulation difficulties and repetitive negative thinking as a maladaptive coping strategy when evaluating sexual distress and suggest that therapeutic interventions targeting such difficulties and thoughts may yield beneficial outcomes., Strengths and Limitations: These findings reinforce the importance of considering the role of emotional regulation difficulties and, consequently, repetitive negative thinking as a dysfunctional coping strategy, when studying and intervening in sexual distress. Future research with clinical samples should be developed to establish better the significance of considering these two dimensions in assessment and therapeutic intervention., Conclusion: Future research should corroborate and expand upon these findings to advance our understanding of sexual distress and optimize interventions in this domain., (© The Author(s) 2023. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Cognitive models of sexual dysfunction postulate that inflexible, unrealistic, and erroneous sexual beliefs work as a vulnerability factor for the development of sexual dysfunctions and existing studies give some support to this hypothesis. However, to date, there is no published systematic review of studies testing the association between men's sexual beliefs and sexual functioning. This systematic review was conducted from searches using EBSCO, PubMed, and Web of Science databases identifying peer-reviewed studies and gray literature sources from inception to November 2021. Twenty cross-sectional studies, assessing correlations between the degree of endorsement of sexual beliefs and sexual functioning and comparing endorsement of sexual beliefs in men with and without sexual problems were included. Despite the small effect sizes, results indicate that higher endorsement of inflexible/unrealistic/erroneous sexual beliefs is associated with poorer sexual functioning and that men presenting with sexual problems tend to report higher endorsement of these sexual beliefs. Further research with clinical samples as well as longitudinal studies are necessary to explore the ways these associations emerge and develop. The state of evidence on this research topic, including gaps and limitations, is discussed.

Objectives: The present review aims to identify the existing evidence on outcome-treatment studies of psychological sexual health interventions in older age., Methods: A systematic search was conducted for studies published until October 2022. Data search was conducted on EBSCO, MEDLINE, Web of Science, and Cochrane Central Register of Controlled Trials databases., Results: From 30,840 screened records, 12 reports were selected. Results were grouped into four categories according to the intervention that was implemented., Conclusions: Despite results presenting some bias concerns, this review suggests that educational and cognitive-behavioral approaches seem to be effective for promoting sexual health in older age., Competing Interests: The authors hold sole responsibility for the views expressed in the manuscript, which may not necessarily reflect the opinion or policy of the Pan American Health Organization., (© 2023 The Author(s). Published with license by Taylor & Francis Group, LLC.)

The prevailing narrative about sexual declines during the transition to parenthood is largely based on studies assessing the average couple, but there is increasing evidence of variability in the sexual well-being of new parents. We sought to establish distinct subgroups of couples based on sexual function and sexual distress trajectories and examine biopsychosocial risk and protective factors of these trajectories. A prospective cohort of 257 first-time parent couples reported on sexual function and sexual distress from 20-week pregnancy (baseline) to 6 months postpartum across four time-points. Biopsychosocial factors were assessed at baseline and 3 months postpartum. Dyadic latent class growth analysis identified two distinct sexual function classes (high, 85%; discrepant, 15%) and three sexual distress classes (low, 77%; moderate, 12%; discrepant, 11%). We identified biomedical (vaginal delivery, perineal tear, breastfeeding) and psychosocial (fatigue, stress, anxiety, depression, attitudes toward sex during pregnancy, relationship quality, perceived partner support) factors that can be assessed at critical time-points (i.e., 20-week pregnancy and 3 months postpartum) to identify high-risk couples. Current results indicate that the course of change in sexual well-being for new parents is heterogeneous, with most new parents retaining high function and low distress and only a minority showing trajectories in which mothers, but not fathers, experience clinically significant and persistent levels of low sexual function and high sexual distress. These results may facilitate more nuanced approaches to the assessment and intervention of new parents' sexual well-being., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Pregnancy and postpartum are associated with declines in body image. Research on postpartum body image focuses almost exclusively on the person who gave birth and studies examining protective factors for postpartum body image are scarce. We assessed 257 new-parent couples from mid-pregnancy to 6-months postpartum to examine whether mindfulness-a recognized contributor to psychological well-being-buffered against declines in both partners' perceptions of mothers' body. Mothers' positive body image and partners' perception of mothers' body were collected at four time-points (second and third trimester; 3- and 6-months postpartum); both partners' mindfulness facets-observing, describing, awareness acting, non-judgement, and non-reactivity-were assessed in the second trimester. Dyadic latent growth curve modeling revealed that both partners' perceptions of mothers' body were positively correlated at all moments; however, mothers' positive body image worsened over time, whereas partners' perception of mothers' body remained stable. Mindfulness facets were positively associated with mothers' positive body image (observe, describe, and non-judging) and fathers' (non-judging) perceptions of mothers' body in pregnancy. Mothers' mindfulness facets (acting with awareness, non-judging) were associated with subsequent trajectories of their own body image. By identifying mindfulness facets as targetable protective factors during pregnancy, these findings have implications for future research and interventions focused on perinatal body image., Competing Interests: Declarations of interest None., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: The Female Sexual Distress Scale and the Female Sexual Distress Scale-Revised-herein called the Sexual Distress Scale (SDS and SDS-R)-are among the most widely used self-report instruments to assess sexual distress, but no version for use in the Portuguese population is available to date., Aim: The current study aimed to validate the Portuguese version of the SDS/SDS-R in samples of women and men with and without distressing sexual problems., Methods: A sample of 1,109 participants without distressing sexual problems (761 women) and 382 participants with distressing sexual problems (283 women), ages ranging from 18 to 72 years, were used to examine the psychometric properties of the Portuguese SDS and SDS-R., Outcomes: Participants completed a survey that included a sociodemographic and health questionnaire, the Portuguese version of the SDS and SDS-R, and measures of sexual satisfaction, sexual quality of life, sexual function, dyadic adjustment, and psychological distress., Results: Results indicated that the Portuguese SDS and the SDS-R assess 1 general domain of sexual distress and showed good evidences of validity based on content and on relations with other variables. Sexual distress was associated with poorer sexual function, satisfaction, and quality of life, with higher psychological distress, and lower dyadic adjustment. Internal consistency and test-retest (1 month) reliabilities were excellent. Tests of differential functioning of items indicated that the SDS and SDS-R scores can be used to compare women and men on sexual distress, but the SDS/SDS-R scores flagged differential functioning of items and test (DFIT) between participants with and without distressing sexual problems., Clinical Translation: Clinicians and researchers can now make use of the SDS and of the SDS-R in the Portuguese population, facilitating the assessment of sexual distress in clinical settings., Strengths & Limitations: The Portuguese SDS/SDS-R scores can be compared between women and men, providing information on sexual distress independently of sexual function. With the current evidence, comparisons between individuals with and without distressing sexual problems should be made with caution, as the scores may be biased against the former., Conclusion: This study provides a validation of the Portuguese version of the SDS/SDS-R that can be used to assess sexual distress in Portuguese women and men and can be used to compare between these 2 groups. Tavares IM, Santos-Iglesias P, Nobre PJ. Psychometric Validation of the Sexual Distress Scale in Male and Female Portuguese Samples. J Sex Med 2022;19:834-845., (Copyright © 2022 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: To investigate sexual excitation (SE) and sexual inhibition (SI) profiles in men with erectile dysfunction (ED) and to examine how these dimensions discriminate between men with and without ED., Methods: A clinical sample of 37 men with situational (psychogenic) ED and a control group of 40 sexually healthy men (matching the clinical group in age, marital status, and educational level) were constituted. Participants completed self-reported questionnaires assessing sexual function and the propensity for SI and SE., Results: Higher propensities for SI due to the threat of performance failure (SIS1, P < .001) and SI due to the threat of performance consequences (SIS2, P < .01) were found in the group of men with ED. No significant differences were found between the 2 groups in the propensity for SE., Conclusion: Findings offer additional support for the Dual Control Model of Sexual Response and underscore the relevance of inhibitory mechanisms as potential psychobiological risk factors for the development and maintenance of ED. Findings also highlight the importance of a multidisciplinary approach in the clinical management of ED., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Despite sexual activity being safe for the majority of expectant couples (i.e., the pregnant individual and their partner), negative attitudes toward having sex during pregnancy are common and are related to lower sexual well-being across this vulnerable life period. Using dyadic response surface analysis in a sample of 254 first-time expectant couples, we examined the degree to which expectant partners demonstrated similar versus dissimilar attitudes to sex during pregnancy and whether specific patterns of couples' similarity in attitudes may uniquely contribute to their sexual satisfaction and sexual distress. Couples' more positive attitudes (i.e., the more both partners perceived sexual activity as non-threatening to their pregnancy), rather than partners' similarity in attitudes, were associated with lower sexual distress for both partners and higher sexual satisfaction for male partners. In couples where partners held more dissimilar attitudes, men demonstrated greater distress when their female partner's attitudes were more positive than their own. To promote sexual well-being during pregnancy, interventions should assist couples to attain stronger positive attitudes to sex during pregnancy by targeting concerns about sex in both expectant partners.

Detrimental biopsychosocial effects of the COVID-19 pandemic on populations have been established worldwide. Despite research indicating that the transition to parenthood is a vulnerable period for maternal and paternal health, an in-depth examination of the specific challenges the pandemic poses for new mothers and fathers is still lacking. Using a mixed-method design, we investigated individual and relational well-being of women and men who were expecting their first child during the first months of the COVID-19 pandemic in Portugal and its associations with contextual, individual, and relational factors. Adults older than 18 ( n = 316, 198 women) from early pregnancy to 6-months postpartum completed a cross-sectional online survey assessing sociodemographic, individual (depression, anxiety, perceived stress), and relational (dyadic adjustment, perceived social support) self-report measures. From those, 99 participants (64 women) responded to an open-ended question and reported perceived changes in their couple's relationship due to the pandemic. Men responding during strict lockdown measures reported significantly higher levels of perceived stress relative to those men who were not under lockdown. Overall, women reported higher levels of depression and greater social support than men. Qualitative analyses resulted in two main themes: Individual Changes and Relational Changes. These themes aggregate personal concerns and experiences (e.g., worsening of mental health, uncertainty about the future, lack of freedom) interrelated with relational issues (e.g., increased togetherness, avoidance of physical contact, and increased availability for parenthood during lockdown). The prevalence of negative effects (58.6%) exceeded the described positive effects (28.3%), and 13.1% described both positive and negative effects of the pandemic. Current findings offer grounds for important evidence-based strategies to mitigate the potential adverse effects of the current pandemic on new mothers' and fathers' individual and relational well-being., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Tavares, Fernandes, Moura, Nobre and Carrito.)

Objectives : The present study aims to assess the relationship between age and sexual satisfaction in older women and testing the potential mediating role of conservative sexual beliefs on this association. Method s: A total of 106 women (M age  = 68.71; SD = 6.31) completed measures of sexual beliefs (SDBQ), sexual functioning (FSFI), and sexual satisfaction (GMSEX). Bivariate correlation analyses were performed to assess the association between age, sexual conservatism, sexual satisfaction, and sexual function. Mediation analysis with bootstrap samples was performed to test the mediating effect of sexual conservatism. Results : Findings suggest a mediating effect of conservative sexual beliefs on the relationship between age and sexual satisfaction in a community-based sample of older women ( F (3,102) = 9.31, p <.001, R 2  = .215). Conclusions : The negative association between sexual conservatism and sexual satisfaction of the participants, and the non-significance of the direct effect of age in sexual satisfaction when including sexual conservatism in the mediation model, highlight the relevance of cognitive factors in sexual health in later life. Clinical Implications : Results such as the mediating role of sexual conservatism on the relationship between age and sexual satisfaction provide opportunities for developing and testing sexual health programs based on the demystification of sexual beliefs.

Background: The Maternal and Partner Sex During Pregnancy Scales (MSP/PSP) are self-report measures of expectant couples' attitudes towards sex during pregnancy., Aim: This study aimed to examine dyadic non-independence of MSP/PSP scores in a sample of expectant couples, while providing an evaluation of factor structure, validity, and reliability of the Portuguese versions of the MSP/PSP. The association between partners' attitudes and frequency of sexual behaviors was also examined., Methods: A total of 189 expectant couples completed a survey that included a sociodemographic questionnaire, the MSP/PSP, frequency of sexual behaviors, as well as validated measures of attitudes to sex, sexual function, sexual satisfaction, depression, and perceived social support., Outcomes: Dyadic interdependence was tested via Pearson correlation between MSP/PSP scores; between-dyads variability was tested via intraclass correlation of the unconditional model including only MSP/PSP scores using a multi-level model. Associations between attitudes and sexual behavior were tested using regression analysis (between-dyads outcomes) or APIM (mixed outcomes). Factor structure, internal consistency, and validity (convergent, discriminant, and concurrent) of the Portuguese versions of the scales were assessed., Results: MSP/PSP scores were interdependent within-dyads. Male partners presented significantly more positive attitudes towards sex during pregnancy than pregnant women. Attitudes were linked to indices of sexual well-being for both partners (sexual functioning, sexual satisfaction) and, for both partners, more positive attitudes were associated with higher frequencies of most partnered sexual behaviors. The Portuguese MSP/PSP scales showed good factor structure, and good to excellent indices of reliability and validity., Clinical Implications: The Portuguese MSP/PSP is adequate for use in couples. The scales can be used to screen partners with negative attitudes towards sex during pregnancy and evaluate how these attitudes relate to intra- and inter-individual sexual well-being during pregnancy., Strengths & Limitations: A strength of this study is the inclusion of both expectant partners and the use of dyadic analysis. Couples who participated in the study were all in mixed-gender/sex relationships, although this was not defined as an inclusion criterion. Future studies should use the MSP/PSP in more diverse samples in order to further determine how the scale performs for couples with different characteristics., Conclusion: Scores in the MSP/PSP are interdependent between mixed-sex/gender expectant couple members. More positive attitudes towards sex during pregnancy are linked to higher frequencies of partnered sexual behaviors and to both partners' greater sexual well-being. Tavares Inês M., Heiman Julia R., Rosen Natalie O., et al. Validation of the Maternal and Partner Sex During Pregnancy Scales (MSP/PSP) in Portugal: Assessing Dyadic Interdependence and Associations with Sexual Behaviors. J Sex Med Rev 2021;18:789-799., (Copyright © 2021 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Orgasmic difficulties are one of the most common sexual complaints among women. Although models of sexual dysfunction propose that cognitive-affective factors are involved in the development and maintenance of sexual difficulties, there is a need to further examine how these factors are associated with orgasmic difficulties specifically., Aim: To analyze differences between women who reported orgasm difficulties and controls in regard to sexual inhibition, sexual excitation, sexual beliefs, as well as negative automatic thoughts and affect during sexual activity., Methods: A total of 500 women, aged 18 to 72 years, completed a Web survey focused on cognitive-affective factors and sexual health. Two hundred fifty women reported orgasm difficulties and were compared with 250 age-matched women who reported no sexual difficulties., Outcomes: Differences between groups regarding sexual inhibition and sexual excitation (Sexual Inhibition/Sexual Excitation Scales-Short Form), sexual beliefs (Sexual Dysfunctional Beliefs Questionnaire), negative automatic thoughts (Automatic Thoughts Subscale of the Sexual Modes Questionnaire), and affect (Positive and Negative Affect Schedule) during sexual activity., Results: Women with orgasm difficulties scored higher on sexual inhibition than controls. They also reported more negative automatic thoughts during sexual activity (concerning failure and disengagement, sexual abuse, lack of affection from partner, passivity, body image) and less erotic thoughts. Women with orgasm difficulties reported experiencing higher negative affect and lower positive affect during sexual activity than women who reported no sexual difficulties. No significant differences were found regarding sexual excitation and endorsement of sexual beliefs., Clinical Implications: Helping women shift their focus from non-erotic, negative thoughts to erotic stimuli, as well as addressing sexual inhibition, can be relevant targets of interventions aimed at women's orgasm difficulties., Strengths & Limitations: Strengths of the study include the use of a large sample of women who reported orgasm difficulties, offering new insights into the clinical importance of these psychological processes. Limitations include the reliance on self-report measures and a relatively homogeneous sample regarding sexual orientation, education, and age., Conclusion: Results highlight the role of cognitive-affective factors on women's orgasm difficulties and emphasize the potential benefit of cognitive-behavioral and/or mindfulness interventions for orgasm difficulties. Moura CV, Tavares IM, Nobre PJ. Cognitive-Affective Factors and Female Orgasm: A Comparative Study on Women With and Without Orgasm Difficulties. J Sex Med 2020;17:2220-2228., (Copyright © 2020 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Introduction: Cognitive factors are conceptualized as playing a role in maintaining psychological disorders-including sexual dysfunction-by influencing the way in which individuals ascribe meaning, and ultimately respond, to sexual events., Objectives: To systematically review and integrate the findings from studies on cognitive processing factors and sexual function and dysfunction in women and men., Methods: A systematic search of major electronic databases was conducted from inception to July 2019 to identify peer-reviewed studies examining cognitive processing factors associated with sexual function and dysfunction. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed., Main Outcome Measure: The main outcome measure was the association of cognitive processing variables with women's and men's sexual function and dysfunction., Results: From 122 studies, 67 studies were deemed eligible for inclusion. Studies demonstrated a consistent association between cognitive processing factors and dimensions of sexual functioning in women and men. The main cognitive processing factors associated with sexual functioning include cognitive distraction and attentional focus, automatic thoughts and sexual cognitions, causal attributions to negative sexual events, efficacy expectations, and perceived performance demands. Specific associations between cognitive processing factors and particular male and female sexual dysfunctions were identified and discussed., Conclusion: Overall, research supports the critical role of cognitive processing factors in predicting women's and men's sexual (dys)function. Evidence suggests that these dimensions should be systematically addressed during the assessment of sexual dysfunction and one of the main treatment targets of psychological interventions. Tavares IM, Moura CV, Nobre PJ. The Role of Cognitive Processing Factors in Sexual Function and Dysfunction in Women and Men: A Systematic Review. Sex Med 2020;8:403-430., (Copyright © 2020 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Cognitive-emotional dimensions play a core role in predisposing and maintaining sexual difficulties. This study aimed to assess the role of personality traits, sexual beliefs, cognitive schemas, automatic thoughts and affective states in predicting sexual functioning in a Portuguese sample. A total of 226 lesbian women, 254 heterosexual women, 243 gay men, and 274 heterosexual men completed a web-survey. For each sample, hierarchical regression analyses were conducted, separately. Results indicated that positive affective states and fewer thoughts associated with failure and disengagement during sexual activity act as significant predictors for sexual functioning, in both lesbian and heterosexual women's groups. Specific predictors of better sexual functioning in lesbian women were lower activation of schemas of undesirability and incompetence, and fewer thoughts associated with sexual abuse, body-image and sexual passivity were, whereas particular predictors of better sexual functioning for heterosexual women were erotic thoughts, lower activation of schemas of undesirability and difference/loneliness, and beliefs related to sexual desire as a sin. For men's groups, the best predictor of sexual functioning was the presence of erotic thoughts. Particularly for gay men's group, fewer failure anticipation thoughts were also a predictor of better sexual functioning. Overall, this study supports the core and predictive role of cognitive-emotional dimensions in sexual functioning for lesbian and heterosexual women, as for gay and heterosexual men.

Background/objective: The transition to parenthood encompasses several psychological and relational changes that might contribute to couples' high levels of stress postpartum. Although common across the postpartum, couples' sexual changes are frequently overlooked., Method: We surveyed 255 mixed-sex new parent couples to examine the associations between sexual well-being-sexual satisfaction, desire, and postpartum sexual concerns-and perceived stress postpartum. Couples completed self-report questionnaires assessing perceived stress and sexual well-being., Results: For both mothers and fathers, greater sexual satisfaction was associated with their partners' lower perceived stress and, for fathers, this was also associated with their own lower perceived stress. For mothers, greater partner-focused sexual desire was associated with their own lower perceived stress whereas, for fathers, greater partner-focused sexual desire was associated with their partners' higher perceived stress. In addition, greater solitary sexual desire and postpartum sexual concerns were associated with both parents' own higher perceived stress., Conclusions: This study highlights the association between sexual well-being and couples' postpartum stress, suggesting that more positive sexual experiences are linked to lower perceptions of stress across this vulnerable period. Couples' sexual well-being may be an important target for interventions aimed at helping postpartum couples cope with stress.

Despite several studies have used the five-factor model (FFM) of personality as theoretical background, few studies have been conducted on the topic of the FFM and sexual aggression. This study explored how the big five dimensions and features of emotional adjustment characterize different forms of sexual violence. Twenty-six male students reporting sexual aggression against women (nonconvicted offenders), 32 convicted rapists, and 33 convicted child sexual molesters were evaluated. Participants completed the Five-Factor Inventory (NEO-FFI), the Brief Symptom Inventory (assessing state emotional adjustment), the Sexual Experiences Survey (perpetration form), and the Socially Desirable Response Set Measure. Results showed that individuals convicted for rape and child sexual abuse presented significantly more neuroticism than nonconvicted sexual offenders; child sex molesters presented significantly less openness than rapists and nonconvicted sexual offenders; and nonconvicted sexual offenders presented significantly less conscientiousness than convicted offenders. Regarding emotional adjustment, convicted rapists revealed marked psychopathological features in relation to child molesters. In addition, convicted rapists and nonconvicted sexual offenders presented significantly more hostility than child sexual molesters. Findings suggested that some of the big five traits as well as state features characterizing emotional adjustment may characterize different types of sexual offenders.

Researchers have demonstrated that several dimensions of sexual functioning (e.g., sexual desire, arousal, orgasm) are associated with the sexual satisfaction of individuals in a committed mixed-sex (male-female) relationship. We extended this research by comparing a dyadic model that included both own (i.e., actor effect) and partner (i.e., partner effect) domains of sexual functioning to an individual model that included only actor effects. Participants were 124 mixed-sex couples who completed online measures of sexual functioning and sexual satisfaction. Data analysis using the actor-partner interdependence model (APIM) and structural equation modeling (SEM) indicated that the dyadic model had a better fit than the individual model. Women's sexual desire and orgasm and men's erectile functioning were significant positive predictors of both own and partner's sexual satisfaction. These results are discussed in terms of the importance of taking a dyadic approach to research and clinical work related to sexual satisfaction.

Infrared thermography (IRT) is a non-contact technique that permits mapping and analysis of the temperature of the body's skin surface. This method has been applied to sexual psychophysiology since the 1980s and its use has been expanding ever since, mainly because it provides several advantages over existing genital response measures. This article presents a review of experimental studies employing IRT to investigate human sexual arousal, with the aim of summarizing the available procedures and evidence so far and to identify important caveats in the literature. The studies reviewed support the feasibility and validity of IRT as a real-time physiological measure of sexual arousal but varied substantially regarding methodology and procedures. The results of this review underscore the value and validity of IRT in sexual psychophysiology and point at the critical need for the standardization of IRT protocols to accommodate the specific needs of applying this methodology to sexual physiology., (Copyright © 2018 Elsevier B.V. All rights reserved.)

The Questionnaire of Cognitive Schema Activation in Sexual Context (QCSASC) is a validated and widespread used measure to assess the self-schemas elicited during sexual negative events in both men and women. The current study aimed to test the psychometric characteristics of the Italian version of the QCSASC in both heterosexual men and women. After linguistic translation, the psychometric properties (internal consistency, construct and discriminant validity) were evaluated in 1038 participants (435 men and 603 women, 767 healthy and 271 clinicals complaining of sexual problems). Confirmatory factor analyses showed a not satisfactory fit of the original factor structure of the QCSASC versions. Principal component analyses were performed highlighting two new factorial structures, further validated with CFAs ("Helpless" and "Unlovable"). Cronbach's alpha, composite reliability and average variance extracted were used as internal consistency measures. Moreover, the QCSASC showed a strong association with emotional response and sexual functioning, being able to differentiate between sexually clinical and control group. Current findings support the validity and the internal consistency of the QCSASC Italian version and allows to assess dysfunctional cognitive schemas activated when facing sexual problematic situations for both clinical and research purposes.

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

The comorbidity between male genital pain and sexual dysfunction is highly prevalent. Previous studies have indicated that men with genital pain share some cognitive characteristics with men experiencing other sexual dysfunctions. However, there is little information on the role of these cognitive factors in understanding the relationship between pain intensity and sexual functioning. This study aims to test if negative sexually related thoughts mediate the relationship between pain intensity and sexual functioning in men with genital pain. A total of 50 men with self-reported genital pain completed an online survey assessing pain intensity, thoughts during sexual activity, and sexual functioning. Results showed a significant effect of negative sexually related thoughts on sexual functioning, β = -.71, t(50) = -4.2, p <.001. Additionally, the Sobel test found a partial mediation effect (z = 2.23, p =.025) and a medium to large indirect effect size was observed (ab cs =.474). Findings suggest that negative sexually related thoughts play an important role in explaining the impact of pain intensity on sexual functioning. Overall, the study emphasizes the relevance of cognitions in predicting sexual function/dysfunction in men with genital pain and suggests the use of cognitive techniques in the treatment of this clinical condition.

Background: The differential role of psychological traits in the etiology and maintenance of female orgasm difficulties is yet to be consistently established., Aim: To investigate the contribution of different psychological trait features (personality, sexual inhibition and excitation, and sexual beliefs) to predict female orgasm and to assess the degree to which these dispositional factors moderate the association between sexual activity and orgasm occurrence in a large community sample of Portuguese women., Methods: 1,002 women (18-72 years, mean age = 26.27, SD = 8.74) completed questionnaires assessing personality traits (NEO-Five Factor Inventory), sexual inhibition and sexual excitation (Sexual Inhibition/Sexual Excitation Scales-Short Form [SIS/SES]), sexual beliefs (Sexual Dysfunctional Beliefs Questionnaire), sexual behavior (frequency of sexual activities and frequency of orgasm occurrence), and social desirability (Socially Desirable Response Set). Hierarchical multiple regression and moderation analyses were conducted while controlling for the effect of covariates such as social desirability, sociodemographic and medical characteristics, and relationship factors., Outcomes: The main outcome measurement was orgasm frequency as predicted and moderated by personality, SIS/SES dimensions, and sexual beliefs., Results: Results of the hierarchical multiple regression analysis indicated a significant predictive role for sexual inhibition (associated with fear of performance failure [SIS1] and related to the threat of performance consequences) and body image beliefs in female orgasm occurrence. The significant predictive effect of extraversion and of sexual excitation on orgasm frequency ceased to be significant with the insertion of all trait predictors in the final model. Furthermore, SIS1 significantly moderated the relation between sexual activity and orgasm occurrence., Clinical Implications: Attention should be given to individual factors impairing orgasmic response in women, particularly sexual inhibition processes. The development of clinical strategies to address and regulate them is recommended., Strengths and Limitations: Although this study investigated a large community sample, this sample was composed of heterosexual, relatively young women and thus generalization of the present results demands some caution. Social desirability was controlled for in the analyses and questionnaires were not collected face to face, which constitutes a strength of this study because social desirability is lower in self-administered online questionnaires compared with paper-and-pencil questionnaires, particularly for more sensitive sexual issues., Conclusion: SIS1 was found to be a vulnerability factor for female orgasmic difficulties. Future research should test these findings with different samples, particularly clinical samples of women with orgasmic problems, preferably with the use of longitudinal designs. Tavares IM, Laan ETM, Nobre PJ. Sexual Inhibition is a Vulnerability Factor for Orgasm Problems in Women. J Sex Med 2018;15:361-372., (Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

The relationship between emotions and sexual functioning has been documented since early sex research. Among other effects, emotions are expected to impact sexual response by shaping individuals' attention to sexual cues; yet, this assumption has not been tested. This study aimed to investigate whether attentional processes to sexual cues are impacted by state emotions, and whether the processes impacted by emotions relate to subjective sexual arousal to a sex film clip. A total of 52 men and 73 women were randomly assigned to one of three experimental conditions: (1) a negative mood induction condition (sadness as dominant emotion), (2) a positive mood induction condition (amusement as dominant emotion), and a (3) neutral/control condition. After mood induction, participants were exposed to a sex film clip while their focus of visual attention was measured using an eye tracker. Three areas of interest (AOI) were considered within the sex clip: background (non-sexual cues), body interaction, and genital interaction. Self-reported attention, thoughts during the sex clip, percent dwell time, and pupil size to AOI were considered as attentional markers. Findings revealed that the attentional processes were not impacted by the mood conditions. Instead, gender effects were found. While men increased their visual attention to the background area of the film clip, women increased attention to the genital area. Also, sexual arousal thoughts during exposure to the sex clip were consistently related to subjective sexual arousal regardless of the momentary emotional state. Findings add to the literature by showing that men and women process the sexual components of a stimulus differently and by challenging the assumption that emotions shape attention to sexual cues.

The present study was aimed at exploring and describing potential psychological and cognitive features characterizing asexual individuals. A web survey targeting a community of single and highly educated asexual individuals (68 women and 19 men) and matching controls (58 women and 19 men) was carried out in volunteers over 18 years old. Participants responded to a set of questions assessing personality traits, state psychopathological dimensions, and sexual beliefs. Findings on asexual women revealed that they reported higher levels of neuroticism, depression, phobic anxiety, personal sensitivity, as well as lower extraversion and conscientiousness than nonasexual women; also, asexual women reported more sexually conservative beliefs (including regarding sexual desire as a sin), beliefs related to the negative impact of age in sexuality, and the primacy of affection in sexual intercourse. Findings on asexual men showed that they reported more neuroticism, openness, psychoticism, and less extraversion. Findings on sexual beliefs showed that asexual men reported more sexually conservative beliefs, more beliefs related to the propensity for believing that women may use sex as a means to subjugate men, and beliefs related to the idea that erectile performance is central to female satisfaction. Findings further suggested that some of these features may have tapped into asexual individuals' religious status.

Background: Cognitive-affective factors contribute to female sexual dysfunctions, defined as clinically significant difficulties in the ability to respond sexually or to experience sexual pleasure. Automatic thoughts and affect presented during sexual activity are acknowledged as maintenance factors for these difficulties. However, there is a lack of studies on the influence of these cognitive-affective dimensions regarding female orgasm., Aim: To assess the role of automatic thoughts and affect during sexual activity in predicting female orgasm occurrence and to investigate the mediator role of these variables in the relation between sexual activity and orgasm occurrence., Methods: Nine hundred twenty-six sexually active heterosexual premenopausal women reported on frequency of sexual activities and frequency of orgasm occurrence, cognitive factors, and social desirability. Participants completed the Sexual Modes Questionnaire-Automatic Thoughts Subscale, the Positive and Negative Affect Schedule, and the Socially Desirable Response Set. Multiple linear regressions and mediation analyses were performed, controlling for the effect of covariates such as social desirability, sociodemographic and medical characteristics, and relationship factors., Outcomes: The main outcome measurement was orgasm frequency as predicted and mediated by automatic thoughts and affect experienced during sexual activities., Results: The presence of failure thoughts and lack of erotic thoughts during sexual activity significantly and negatively predicted female orgasm, whereas positive affect experienced during sexual activity significantly and positively predicted female orgasm. Moreover, negative automatic thoughts and positive affect during sexual activity were found to mediate the relation between sexual activity and female orgasm occurrence., Clinical Implications: These data suggest that the cognitive aspects of sexual involvement are critical to enhancing female orgasm experience and can aid the development of strategies that contemplate the central role of automatic thoughts and of positive emotions experienced during sexual activity., Strengths and Limitations: Data were not collected face to face, which constitutes a strength of this study, because it is known that social desirability is lower in self-administered online questionnaires compared with traditional paper-and-pencil questionnaires, particularly for more sensitive sexual issues. The fact that the sample was composed of heterosexual, premenopausal, and relatively young women demands some caution regarding generalization of the present results., Conclusion: The findings support the contribution of cognitive and affective factors to female orgasmic functioning. It is recommended that future research confirm these findings with other samples, particularly clinical samples of women with orgasmic difficulties. Tavares IM, Laan ETM, Nobre PJ. Cognitive-Affective Dimensions of Female Orgasm: The Role of Automatic Thoughts and Affect During Sexual Activity. J Sex Med 2017;14:818-828., (Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Sexual aggression as committed by women has been the target of little empirical research and is still regarded as a myth by many people. The aim of this study was to evaluate the psychosexual profile of young and educated women reporting sexual aggression against men. This is a cross-sectional study; a total of 260 female college students answered to an online survey. Among them, 93 (35.8%) reported having committed some form of sexual aggression against men: 46.2% of sexually aggressive women fell into the category of sexual coercion, 34.1% fell into the category of sexual abuse, and 19.8% reported having used physical force. Findings revealed that sexually aggressive women reported significantly higher levels of sociosexuality, sexual fantasies of dominance and submission, sexual compulsivity, sexual excitation, and sexual inhibition due to the threat of sexual performance failure. Data are expected to affect prevention strategies for a relevant yet understudied social concern., (© The Author(s) 2015.)

Introduction: Validated instruments for assessing specific thought content during exposure to sexually explicit material are lacking., Aim: To investigate the psychometric properties of a measure that assesses self-reported thoughts during exposure to sexual stimuli in laboratory settings, namely the Sexual Thoughts Questionnaire. The factorial structure of the questionnaire and its reliability and validity were examined., Methods: One hundred sixty-seven sexually functional individuals (97 women and 70 men) were exposed to sexually explicit material while their genital arousal was being assessed. Subjective sexual arousal and thoughts during exposure to sexually explicit material also were assessed., Main Outcome Measures: Women's genital arousal was measured with a vaginal photoplethysmograph and men's genital arousal was measured with an indium-gallium strain gauge. Subjective sexual arousal and thoughts during exposure to erotica were assessed with self-report scales., Results: Principal component analysis with varimax rotation identified five factors: sexual arousal thoughts, distractive and disengaging thoughts, body image and performance thoughts, actress's physical attractiveness thoughts, and sinful and lack of affection thoughts. Moreover, the scale showed satisfactory levels of internal consistency. Studies on convergent validity showed an association between self-reported thoughts and subjective sexual arousal levels in the women and men., Conclusion: The Sexual Thoughts Questionnaire showed adequate psychometric properties in a sexually functional sample. It could be useful in further experimental research on the role of cognitions in sexual response and allow further comparison between sexually functional and dysfunctional individuals, with possible significant implications for the assessment and treatment of sexual problems., (Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

Sexual offenders, in general, report problematic rearing practices from their parents, lacking however more empirical research on this topic regarding particular subtypes of offenders. The current study examined the relationship between early parenting styles and different types of sexual offending. A total of 113 sexual offenders (rapists, pedophilic and nonpedophilic child molesters), and 51 nonsexual offenders completed the EMBU (My Memories of Upbringing), the Brief Symptom Inventory, and the Socially Desirable Response Set Measure. Results showed that rapists were less likely to remember their fathers as being emotionally warm compared with nonsexual offenders and pedophilic child molesters. In addition, compared with rapists, pedophilic offenders perceived their mothers as having been less emotionally warm to them. Overall, results showed that certain developmental experiences with parents were able to distinguish between subtypes of offenders supporting an association between distal interpersonal factors and sexual offending. These findings may have important implications for early intervention and prevention of sexual crimes. Further research using larger samples of pedophilic child molesters is recommended., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Introduction: Leprosy is a public health problem in Brazil where 31,044 new cases were detected in 2013. Rio Grande do Norte is a small Brazilian state with a rate of leprosy lower than other areas in the same region, for unknown reasons., Objectives: We present here a review based on the analysis of a database of registered leprosy cases in Rio Grande do Norte state, comparing leprosy's geographic distribution among municipalities with local socio-economic and public health indicators and with historical documents about human migration in this Brazilian region., Results: The current distribution of leprosy in Rio Grande do Norte did not show correlation with socio-economic or public health indicators at the municipal level, but it appears related to economically emerging municipalities 100 years ago, with spread facilitated by railroads and train stations. Drought-related migratory movements which occurred from this state to leprosy endemic areas within the same period may be involved in the introduction of leprosy and with its present distribution within Rio Grande do Norte., Conclusions: Leprosy may disseminate slowly, over many decades in certain circumstances, such as in small cities with few cases. This is a very unusual situation currently and a unique opportunity for epidemiologic studies of leprosy as an emerging disease.

Although the role of interpersonal factors on sexual offending is already recognized, there is a need for further investigation on the psychosocial correlates of pedophilic behavior. This study aimed to examine the relationship between adult interpersonal features and subtypes of sexual offending. The study involved the participation of a total of 164 male convicted offenders namely 50 rapists, 63 child molesters (20 pedophilic and 43 nonpedophilic), and 51 nonsexual offenders. All participants were assessed using the Adult Attachment Scale, the Interpersonal Behavior Survey, the Brief Symptom Inventory, and the Socially Desirable Response Set Measure. Results from sets of multinomial logistic regression analyses showed that pedophilic offenders were more likely to present anxiety in adult relationships compared to nonsex offenders. Likewise, nonpedophilic child molesters were less likely to be generally aggressive compared to rapists and nonsex offenders, as well as less generally assertive than rapists. Overall, findings indicated that certain interpersonal features characterized subtypes of offenders, thus providing some insight on their particular therapeutic needs. Further replications with larger samples particularly of pedophilic child molesters are required., (Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

Despite the important focus on the notion of cognitive distortions in the sexual offending area, the relevance of underlying cognitive schemas in sexual offenders has also been suggested. The aim of the present study was to investigate a potential relationship between Early Maladaptive Schemas (EMSs) and cognitive distortions in rapists. A total of 33 men convicted for rape completed the Bumby Rape Scale (BRS), the Young Schema Questionnaire - Short form-3 (YSQ-S3), the Brief Symptom Inventory (BSI), and the Socially Desirable Response Set Measure (SDRS-5). Results showed a significant relationship between the impaired limits schematic domain and the Justifying Rape dimension of the BRS. Specifically, after controlling for psychological distress levels and social desirability tendency, the entitlement/grandiosity schema from the impaired limits domain was a significant predictor of cognitive distortions related to Justifying Rape themes. Overall, despite preliminary, there is some evidence that the Young's Schema-Focused model namely the impaired limits dimension may contribute for the conceptualization of cognitive distortions in rapists and further investigation is recommended., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Sexual compulsivity in women has been understudied. Furthermore, studies on this topic usually consider clinical samples of individuals assigned to the label of sexual addicts and presenting strong psychiatric comorbidities. Consequently, there is missing evidence on the relation between psychological factors and sexual compulsivity in the absence of significant psychiatric disturbance. Such disturbance may mask the psychological dimensions underpinning sexual compulsivity. Against this background, this study used a nonpathological frame to explore this relation because it may add relevant information on the topic of female sexual compulsivity. Two-hundred thirty-five female college students were eligible for the study. Participants completed self-report questionnaires on the following topics: trait affect, impulsiveness, psychological symptoms, alexithymia, sexual response in states of anxiety versus depressive mood, and coping skills. Findings revealed that motor/planning impulsiveness and psychoticism significantly predicted sexual compulsivity in women. Data have suggested that when sexual compulsivity is measured as a continuous construct in a community sample of women, only some factors seem common to those found in severe forms of hypersexuality.

Symptoms of persistent genital arousal are expected to negatively affect women's sexual and emotional well-being. However, not all women who experience persistent genital arousal complain about their genital condition. Against this background, this study aimed to evaluate psychological predictors of the distress associated with persistent genital arousal symptoms, as well as psychological moderators influencing the conditions under which persistent genital arousal causes distress. A total of 117 women reporting symptoms of persistent genital arousal answered to online questionnaires measuring personality traits, sexual beliefs, and dyadic adjustment. Women have also completed a checklist measuring the frequency/severity of persistent genital arousal symptoms and the distress/impairment caused by these symptoms. Results showed that neuroticism, (low) openness, sexual conservatism, and (low) dyadic adjustment significantly predicted distress associated with genital symptoms. Furthermore, sexual conservatism was found to moderate the relation between the symptoms' severity and the distress associated with those symptoms. Overall, sexual conservatism seems to be a key differentiator factor, influencing the psychological conditions under which women may report higher levels of distress caused by persistent genital arousal. Because such findings focus on the distress to genital arousal symptoms rather than on persistent genital arousal disorder as a clinical entity, the results under consideration may or may not characterize women formally assigned to the persistent genital arousal disorder label.

Introduction: Both emotions and cognitions seem to play a role in determining sexual arousal. However, no studies to date have tested the effects of self-reported thoughts on subjective sexual arousal and genital response using psychophysiological methods., Aim: The aim of the present study was to evaluate the role of self-reported thoughts and affect during exposure to erotic material in predicting subjective and genital responses in sexually healthy men., Methods: Twenty-seven men were presented with two explicit films, and genital responses, subjective sexual arousal, self-reported thoughts, and positive and negative affect were assessed., Main Outcome Measures: Men's genital responses, subjective sexual arousal, affective responses, and self-reported thoughts during exposure to sexual stimulus were measured., Results: Regression analyses revealed that genital responses were predicted by self-reported thoughts (explaining 20% of the variance) but not by affect during exposure to erotic films. On the other hand, subjective sexual arousal was significantly predicted by both positive and negative affect (explaining 18% of the variance) and self-reported thoughts (explaining 37% of the variance). Follow-up analyses using the single predictors showed that "sexual arousal thoughts" were the only significant predictor of subjective response (β = 0.64; P < 0.01) and that "distracting/disengaging thoughts" were the best predictor of genital response (β = -0.51; P < 0.05)., Conclusions: The findings of this study suggest that both affect and sexual arousal thoughts play an important role in men's subjective sexual response, whereas genital response seems to be better predicted by distracting thoughts., (© 2014 International Society for Sexual Medicine.)

Introduction: The specific cognitive-affective mechanisms involved in the activation and regulation of the subjective and genital components of sexual arousal are not fully understood yet., Aim: The aim of the present study was to investigate the contribution of self-reported thoughts and affect to the prediction of women's subjective and genital responses to erotica., Methods: Twenty-eight sexually functional women (mean age = 32, SD = 6.29) were presented with sexually explicit and nonexplicit romantic films. Genital responses, subjective sexual arousal, state affect, and self-reported thoughts were assessed., Main Outcome Measures: Vaginal pulse amplitude was measured using a vaginal photoplethysmograph. Subjective sexual arousal, thoughts, and affective responses were assessed through self-report scales., Results: Correlations between subjective and physiological sexual arousal were low (r = -0.05, P > 0.05). Self-reported thoughts and affect were significant predictors of subjective sexual arousal. The strongest single predictor of subjective arousal was sexual arousal thoughts (e.g., "I'm getting excited") (β = 0.63, P < 0.01). None of the cognitive or affective variables predicted women's genital responses., Conclusions: Overall, results support the role of cognitive (self-reported thoughts) and affective dimensions in women's subjective sexual arousal to erotica and, consistent with previous findings, suggest that subjective and physiological sexual arousal may be impacted by different processes., (© 2014 International Society for Sexual Medicine.)

Core cognitive schemas may play a role in the vulnerability for sexual offending. Identifying these schemas could help to conceptualize sexual crimes and rehabilitate convicted sexual offenders. The aim of this preliminary study was to explore the relationship between early maladaptive schemas (EMSs) and sexual offending, as well as how rapists and child sex molesters differ in terms of these schemas. Thirty-two men convicted for rape, 33 convicted for child sexual abuse, and 30 non-offenders were evaluated using the Young Schema Questionnaire (YSQ-S3) and the Brief Symptom Inventory (BSI). Results showed that participants convicted for child sexual abuse presented significantly more schemas from the disconnection/rejection, impaired autonomy/performance, other directness, and over vigilance/inhibition domains than non-offenders, whereas rapists presented more schemas from the impaired autonomy/performance domain than non-offenders. Differences between sex offenders showed that child molesters presented more schemas of pessimism than rapists. Preliminary findings suggested that EMSs may impact sex offender's perceptions about themselves and about the world. Schema-focused therapy (Young, 1990, 1999) may thus be an acceptable approach to sex offender's psychological assessment and intervention., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Despite the use of different methodologies, target populations, and clinical definitions of sexual problems, recent epidemiological studies have shown that the occurrence of sexual difficulties is a very common experience among men from the general population regardless of their age. The objective of this study was to present epidemiological data on the prevalence of sexual difficulties in a community sample of 650 sexually active Portuguese men, stratified by age, marital status, and educational level. Participants completed a self-reported questionnaire assessing sexual function in the previous four weeks (International Index of Erectile Function). Results showed that sexual difficulties were relatively common among this sample. Rapid ejaculation was the most frequently reported sexual difficulty (23.2%), followed by erectile difficulties (10.2%), orgasm problems (8.2%), and low desire (2.9%) in the previous four weeks. With the exception of rapid ejaculation, all categories showed age-specific prevalence rates, with sexual difficulties increasing gradually in men above age 45. Age was a significant predictor of all sexual difficulties except rapid ejaculation, and lower educational levels were related to orgasm difficulties. Findings are consistent with the majority of epidemiological studies indicating a high prevalence of sexual difficulties among men in the general population and highlight the importance and the need to implement sexual health promotion programs in the target population.