The Relationship Between Dimensions of Adult Attachment and Motivation for Faking Orgasm in Women.

Attachment and sexual behavior are both integral parts of adult romantic relationships. Attachment avoidance is linked to impersonal, egocentric sexual activities, whereas the sexuality of anxiously attached individuals revolves around relationship maintenance and the needs of the partner. In this attachment context, faking orgasm might serve as a means for relational regulation. The aim of our study was to investigate the links between dimensions of adult attachment and motives for faking orgasm in women. Young women completed measures of adult attachment and motivations for faking orgasm. Both attachment avoidance and attachment anxiety were related to the use of faked orgasm as a means to avoid negative, shameful feelings. Attachment avoidance was significantly associated with the intention to quickly end sexual intercourse through faking orgasm. Attachment anxiety was associated with the use of faked orgasm to increase sexual arousal and to elevate partners' self-esteem. Results are discussed with regard to relational and sexual goals associated with adult attachment orientations.

The faking orgasm scale for women: psychometric properties.

The Faking Orgasm Scale for Women (FOS) was designed to assess women's self-reported motives for faking orgasm during oral sex and sexual intercourse. Exploratory factor analysis (EFA) was conducted on the responses of 481 heterosexual undergraduate females (M age = 20.33 years, SD = 2.48). Results of the EFA revealed that the FOS-Sexual Intercourse Subscale was composed of four factors: (1) Altruistic Deceit, faking orgasm out of concern for a partner's feelings; (2) Fear and Insecurity, faking orgasm to avoid negative emotions associated with the sexual experience; (3) Elevated Arousal, a woman's attempt to increase her own arousal through faking orgasm; and (4) Sexual Adjournment, faking orgasm to end sex. The analysis of the FOS-Oral Sex Subscale yielded four factors: (1) Altruistic Deceit; (2) Insecure Avoidance, faking orgasm to avoid feelings of insecurity; (3) Elevated Arousal; and (4) Fear of Dysfunction, faking orgasm to cope with concerns of being abnormal. Each factor of the two subscales was found to have excellent internal consistency. Confirmatory factor analysis on a separate sample of 398 heterosexual female undergraduates (M age = 20.52 years, SD = 2.55) confirmed the factor structure of each subscale with excellent fit statistics. The FOS should allow researchers and clinicians to better understand why women fake orgasm. Deepening this understanding may serve future research examining sexual desire, satisfaction, and dysfunction as well as have applications in sex and couples' therapy.

Facets of perfectionism in a sample of hypersexual patients.

This study investigated the role of perfectionism in a treatment-seeking sample (N = 136) of adult men and women using the Perfectionism Inventory (PI) and the Hypersexual Behavior Inventory (HBI). Several facets of perfectionism were positively correlated with hypersexuality, with the concern over mistakes scale from the PI accounting for most of the predictive variance in patterns of hypersexual behavior measured by the HBI. Items associated with concern over mistakes closely parallel the construct of shame noted in other studies of hypersexual patients. To a lesser degree, the PI scale planfulness also showed a negative relationship with hypersexuality, suggesting tendencies of impulsivity in the current patients. These data reinforce the findings in other studies that patterns of harsh self-criticism and impulsivity seem to strongly influence hypersexual behavior.

Report of findings in a DSM-5 field trial for hypersexual disorder.

INTRODUCTION: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for hypersexual disorder (HD) have been proposed to capture symptoms reported by patients seeking help for out-of-control sexual behavior. The proposed criteria created by the DSM-5 Work Group on Sexual and Gender Identity Disorders require evaluation in a formal field trial. AIM: This DSM-5 Field Trial was designed to assess the reliability and validity of the criteria for HD in a sample of patients seeking treatment for hypersexual behavior, a general psychiatric condition, or a substance-related disorder. METHOD: Patients (N = 207) were assessed for psychopathology and HD by blinded raters to determine inter-rater reliability of the HD criteria and following a 2-week interval by a third rater to evaluate the stability of the HD criteria over time. Patients also completed a number of self-report measures to assess the validity of the HD criteria. MAIN OUTCOME MEASURES: HD and psychopathology were measured by structured diagnostic interviews, the Hypersexual Behavior Inventory, Sexual Compulsivity Scale, and Hypersexual Behavior Consequences Scale. Emotional dysregulation and stress proneness were measured by facets on the NEO Personality Inventory-Revised. RESULTS: Inter-rater reliability was high and the HD criteria showed good stability over time. Sensitivity and specificity indices showed that the criteria for HD accurately reflected the presenting problem among patients. The diagnostic criteria for HD showed good validity with theoretically related measures of hypersexuality, impulsivity, emotional dysregulation, and stress proneness, as well as good internal consistency. Patients assessed for HD also reported a vast array of consequences for hypersexual behavior that were significantly greater than those diagnosed with a general psychiatric condition or substance-related disorder. CONCLUSIONS: The HD criteria proposed by the DSM-5 Work Group on Sexual and Gender Identity Disorders appear to demonstrate high reliability and validity when applied to patients in a clinical setting among a group of raters with modest training on assessing HD.

Glycopyrrolate for treatment of clozapine-induced sialorrhea in three adolescents.

OBJECTIVE: The aim of this case study was to report preliminary data on the effectiveness and tolerability of glycopyrrolate for the treatment of clozapine-induced sialorrhea, or excessive flow of saliva, in an adolescent population. METHOD: Three adolescent females (age 13-16), who developed sialorrhea secondary to clozapine treatment, received an open-label trial of glycopyrrolate (4-8 mg) during inpatient hospitalization for treatment-resistant psychotic illness. RESULTS: The target symptom of sialorrhea was improved in all three cases, with patient self-reports of decreased production of saliva confirmed by staff observation. Glycopyrrolate was generally well tolerated by the patients. One patient reported constipation, which improved with symptomatic treatment. A second patient reported dry mouth, which improved with a reduction in dose of glycopyrrolate. CONCLUSIONS: These three cases provide support for the potential effectiveness and tolerability of glycopyrrolate for clozapine-induced sialorrhea in adolescents. Further controlled studies are required to determine the safety, efficacy and tolerability of glycopyrrolate in this age group and in adults for clozapine-induced sialorrhea.