The Role of Men's Sexual Beliefs on Sexual Function/Dysfunction: A Systematic Review.

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.

Adapting to Uncertainty: A Mixed-Method Study on the Effects of the COVID-19 Pandemic on Expectant and Postpartum Women and Men.

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.

Cognitive-Affective Factors and Female Orgasm: A Comparative Study on Women With and Without Orgasm Difficulties.

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.

The Role of Cognitive Processing Factors in Sexual Function and Dysfunction in Women and Men: A Systematic Review.

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.