Menstrual Cycle Changes in Daily Sexual Motivation and Behavior Among Sexually Diverse Cisgender Women.

We used a one-month daily diary assessment to measure menstrual cycle-related changes in same-gender and other-gender sexual motivation and behavior in 148 cisgender women (32% lesbian-identified, 35% bisexually identified, and 33% heterosexual-identified). Women with exclusive same-gender orientations reported increased motivation for same-gender sexual contact during the higher-fertility phase of the cycle, but women with exclusive other-gender orientations did not show a parallel increase in other-gender sexual motivation during the higher-fertility phase. Bisexually attracted women showed no phase-related changes in same-gender or other-gender sexual motivation, regardless of whether they generally preferred one gender versus the other. Rates of partnered sexual contact did not increase during the higher-fertility phase. During the 14 midcycle days during which we assayed salivary estrogen and testosterone, we found no significant associations between daily hormones and sexual motivation. However, daily estrogen levels were positively related to sexual behavior among women currently partnered with women, and negatively related to sexual behavior among women currently partnered with men. Our results suggest that traditional evolutionary models of menstrual cycle-related changes in sexual motivation do not adequately reflect the full range of cycle-related changes observed among sexually diverse women.

Understanding heterosexual women's erotic flexibility: the role of attention in sexual evaluations and neural responses to sexual stimuli.

Many women experience desires, arousal and behavior that run counter to their sexual orientation (orientation inconsistent, 'OI'). Are such OI sexual experiences cognitively and neurobiologically distinct from those that are consistent with one's sexual orientation (orientation consistent, 'OC')? To address this question, we employed a mindful attention intervention-aimed at reducing judgment and enhancing somatosensory attention-to examine the underlying attentional and neurobiological processes of OC and OI sexual stimuli among predominantly heterosexual women. Women exhibited greater neural activity in response to OC, compared to OI, sexual stimuli in regions associated with implicit visual processing, volitional appraisal and attention. In contrast, women exhibited greater neural activity to OI, relative to OC, sexual stimuli in regions associated with complex visual processing and attentional shifting. Mindfully attending to OC sexual stimuli reduced distraction, amplified women's evaluations of OC stimuli as sexually arousing and deactivated the superior cerebellum. In contrast, mindfully attending to OI sexual stimuli amplified distraction, decreased women's evaluations of OI stimuli as sexually arousing and augmented parietal and temporo-occipital activity. Results of the current study constrain hypotheses of female erotic flexibility, suggesting that sexual orientation may be maintained by differences in attentional processing that cannot be voluntarily altered.

Corrigendum: Subjective and Oxytocinergic Responses to Mindfulness Are Associated With Subjective and Oxytocinergic Responses to Sexual Arousal.

[This corrects the article DOI: 10.3389/fpsyg.2019.01101.].

Subjective and Oxytocinergic Responses to Mindfulness Are Associated With Subjective and Oxytocinergic Responses to Sexual Arousal.

Mindfulness - the ability to pay attention, on purpose, without judgment, and in the present moment - has consistently been shown to enhance women's sexual arousal. As a first step toward understanding potential neuroendocrine underpinnings of mindfulness and sexual arousal, we examined whether individual differences in subjective and neuroendocrine (i.e., oxytocin) responses to mindful breathing were associated with individual differences in subjective and neuroendocrine responses to sexual arousal. To achieve this aim, 61 lesbian, bisexual, and heterosexual women completed a questionnaire assessing dispositional mindfulness, underwent an arousal task while continuously rating their sexual arousal and a mindful breathing task, after which participants reported on their ability to detect attentional shifts, and provided salivary samples after each assessment. Results indicated that women who were quicker to detect attentional shifts and women who reported greater sexual arousability reported larger changes (decreases) in oxytocin in response to mindful breathing and were the only women to report increases in oxytocin in response to the sexual arousal induction. Results further indicated that individuals who report greater subjective responsiveness to mindfulness and sexual arousal appear to have an oxytocinergic system that is also more responsive to both arousal and to mindfulness. These results make a significant contribution to our understanding of the role of attentional processes in sexual arousal, and warrant future examination of oxytocin as a potential neuroendocrine mechanism underlying the link between mindfulness and sexual arousal.

Prevalence of Distress Associated With Difficulty Controlling Sexual Urges, Feelings, and Behaviors in the United States.

Importance: The veracity, nomenclature, and conceptualizations of sex addiction, out-of-control sexual behavior, hypersexual behavior, and impulsive or compulsive sexual behavior are widely debated. Despite such variation in conceptualization, all models concur on the prominent feature: failing to control one's sexual feelings and behaviors in a way that causes substantial distress and/or impairment in functioning. However, the prevalence of the issue in the United States is unknown. Objective: To assess the prevalence of distress and impairment associated with difficulty controlling sexual feelings, urges, and behaviors among a nationally representative sample in the United States. Design, Setting, and Participants: This survey study used National Survey of Sexual Health and Behavior data to assess the prevalence of distress and impairment associated with difficulty controlling sexual feelings, urges, and behaviors and determined how prevalence varied across sociodemographic variables. Participants between the ages of 18 and 50 years were randomly sampled from all 50 US states in November 2016. Main Outcomes and Measures: Distress and impairment associated with difficulty controlling sexual feelings, urges, and behavior were measured using the Compulsive Sexual Behavior Inventory-13. A score of 35 or higher on a scale of 0 to 65 indicated clinically relevant levels of distress and/or impairment. Results: Of 2325 adults (1174 [50.5%] female; mean [SD] age, 34.0 [9.3] years), 201 [8.6%] met the clinical screen cut point of a score of 35 or higher on the Compulsive Sexual Behavior Inventory. Gender differences were smaller than previously theorized, with 10.3% of men and 7.0% of women endorsing clinically relevant levels of distress and/or impairment associated with difficulty controlling sexual feelings, urges, and behavior. Conclusions and Relevance: The high prevalence of this prominent feature associated with compulsive sexual behavior disorder has important implications for health care professionals and society. Health care professionals should be alert to the high number of people who are distressed about their sexual behavior, carefully assess the nature of the problem within its sociocultural context, and find appropriate treatments for both men and women.

Stability of Sexual Attractions Across Different Timescales: The Roles of Bisexuality and Gender.

We examined the stability of same-sex and other-sex attractions among 294 heterosexual, lesbian, gay, and bisexual men and women between the ages of 18 and 40 years. Participants used online daily diaries to report the intensity of each day's strongest same-sex and other-sex attraction, and they also reported on changes they recalled experiencing in their attractions since adolescence. We used multilevel dynamical systems models to examine individual differences in the stability of daily attractions (stability, in these models, denotes the tendency for attractions to "self-correct" toward a person-specific setpoint over time). Women's attractions showed less day-to-day stability than men's, consistent with the notion of female sexual fluidity (i.e., heightened erotic sensitivity to situational and contextual influences). Yet, women did not recollect larger post-adolescent changes in sexual attractions than did men, and larger recollected post-adolescent changes did not predict lower day-to-day stability in the sample as a whole. Bisexually attracted individuals recollected larger post-adolescent changes in their attractions, and they showed lower day-to-day stability in attractions to their "less-preferred" gender, compared to individuals with exclusive same-sex or exclusive other-sex attractions. Our results suggest that both gender and bisexuality have independent influences on sexual fluidity, but these influences vary across short versus long timescales, and they also differ for attractions to one's "more-preferred" versus "less-preferred" gender.

The Relationship Between Sexual Activity and Depressive Symptoms in Lesbian, Gay, and Bisexual Youth: Effects of Gender and Family Support.

There is considerable debate over whether adolescent sexual activity is maladaptive and associated with worse mental health outcomes versus a positive developmental milestone that is associated with better mental health outcomes. Although these perspectives are often pitted against one another, the current study employed a more integrative perspective: adolescent sexual activity may be maladaptive in certain contexts, but healthy in other contexts. We investigated whether family support and gender moderated the relation between sexual activity and mental health outcomes in a diverse sample of 519 lesbian, gay, and bisexual (LGB) youth. Specifically, we examined whether youth who engaged in more sexual activity would have fewer depressive symptoms in the context of a more supportive family environment, but more depressive symptoms in the context of a less supportive family environment and whether this effect was stronger for sexual minority girls. Consistent with the sexual health perspective, we found that among girls with more family support, those who engaged in more frequent same-sex sexual contact had lower levels of depressive symptoms. Unexpectedly, we found that among boys with more family support, those who engaged in more frequent same-sex sexual contact had higher levels of depressive symptoms. In contrast, girls and boys with less family support showed no relation between sexual activity and depressive symptoms. Overall, results suggest that context is critical when determining whether same-sex sexual contact among LGB youth should be considered maladaptive or beneficial.

The interpersonal process model of demand/withdraw behavior.

The demand/withdraw interaction pattern is a destructive cycle of relationship communication behavior that is associated with negative individual and relationship outcomes. Demand/withdraw behavior is thought to be strongly linked to partners' emotional reactions, but current theories are inconsistent with empirical findings. The current study proposes the interpersonal process model of demand/withdraw behavior, which includes linkages between each partners' emotional reactions and the interpersonal behavior of demanding and withdrawing. Data come from problem solving discussions of 55 German couples with observationally coded demand/withdraw behavior and fundamental frequency (f0) to measure vocally encoded emotional arousal. Actor-partner interdependence models (Kenny, Kashy, & Cook, 2006) were used to examine associations among demand/withdraw behavior and f0 in the overall discussion and 5-min segments. Significant cross-partner associations emerged for demanding and withdrawing behavior across the whole conversation as well as within 5-min segments, and these associations are partially accounted for by each individual's f0. When behaviorally coded demanders expressed more vocal arousal, they demanded more and withdrew less while their partners withdrew more. In contrast, when behaviorally coded withdrawers expressed more vocal arousal, their partners demanded less and withdrew more. Findings demonstrate that demand/withdraw behavior varies between couples (i.e., some couples engage in a stronger demand/withdraw cycle than others) and between segments (i.e., when 1 partner increases demanding, the other increases withdrawing). Findings support key elements of the interpersonal process model, showing intra- and interpersonal pathways linking demand/withdraw behavior and emotion and demonstrate the importance of partners' behavioral roles in these linkages.