Links between perceived parent characteristics and attachment variables for young women from intact families.

This study examined links between perceived parent characteristics and attachment variables for young women from intact families (biological parents still married to each other). One hundred fifty-four female college students served as subjects. They rated both parents using items derived from Secunda's (1992) descriptions of father characteristics, and also were assessed on measures of adult attachment, self-esteem, and interpersonal trust. Positive correlations were found between secure attachment and self-concept, good father characteristics, and doting mother characteristics. An insecure attachment pattern was associated with lower self-worth, less interpersonal trust, distant and demanding father characteristics, and absent mother characteristics. A fearful attachment pattern was associated with distant father and absent mother characteristics. A preoccupied attachment pattern was linked to absent, seductive, and demanding father characteristics and demanding mother characteristics. A dismissive attachment pattern was associated with distant father characteristics. Collectively, father characteristics related more strongly to an insecure attachment pattern, while mother characteristics related more strongly to a secure attachment pattern.

Treatment outcome of secondary orgasmic dysfunction: a two- to six-year follow-up.

Sixty-six women reporting secondary orgasmic dysfunction and their partners, who received one of five group treatment formats, were sent questionnaires 2-6 years later. Thirty-eight of the women and 38 of the male partners responded to the follow-up questionnaires. Women who were not divorced and who did not receive additional treatment after group treatment (n = 28) showed consistent increases across time in their ability to experience orgasm during intercourse, improving from a mean coital orgasmic frequency of 9.5% before treatment to 36.9% at long-term follow-up. Sexual harmony and coital frequency showed similar increases following treatment but had returned to near baseline levels 2-6 years later. Divorced women and women who received additional treatment (n = 10) demonstrated greater declines in sexual harmony over the follow-up period than did their untreated counterparts. The subjects reported generally favorable reactions to treatment and stressed the importance of a treatment focus on communication and relationship skills. Regression analyses suggested the predictive importance of variables associated with the male partner's functioning. The implications of the results for clinical practice and for future research are discussed.

The impact of augmentation mammaplasty: a follow-up study.

Seventy-five women who had undergone augmentation mammaplasty responded to a questionnaire that obtained their perceptions of five areas of their personal and relationship functioning: (1) body and self-image, (2) attractiveness, (3) sensual sensitivity of breasts, (4) sexual life, and (5) relationship with partner. The women's perceptions of these areas before and after surgery were obtained retrospectively (between 3 months and 3 years after surgery). The 54 women in consistent relationships reported positive effects of the surgery on their relationship, although not to the extent that they had anticipated. However, regardless of this finding, these women perceived surgery to have had significant positive effects on their attractiveness, as well as on their body and self-image. Postoperatively, the partners of these women were viewed as having a significantly greater interest in sexual activity, as perceiving the women to be significantly more attractive, and as believing that the sexual relationship was significantly enhanced. The 21 women who were not in a consistent relationship also reported positive postoperative changes, although these were not statistically significant. Neither the women's age, length of time since surgery, nor the duration of the woman's relationship had any effect on the positive changes reported. The quantitative and qualitative data underscored the highly positive benefits of breast augmentation for the respondents.

Group treatment of secondary erectile dysfunction.

The effects of three group treatment formats on 20 men with secondary erectile dysfunction and their partners were contrasted. After a comprehensive medical and psychological screening, each couple was assigned to one of three treatment groups (Communication Technique Training, Sexual Technique Training, Combination Treatment) or to one of two control groups (Attention-Placebo, No-Treatment). Couples in the three treatment groups and the attention-placebo group participated in their respective formats in twice-weekly sessions for a total of 20 hours. The no-treatment control group received sex education and treatment after a 5-week waiting list period. All three treatment groups fostered substantial gains so that between-format differences were not statistically significant. Subject variables which predicted success/experience ratio gains included age of the male partner, perceived level of relationship adjustment, and the male partner's success/experience ratio prior to treatment. Eighty-one percent of the treated men reached the criterion of 80% or greater success/experience ratio (successful penetration and subsequent ejaculation) at the 6-month follow-up. Good nocturnal tumescence prior to treatment was correlated with a better treatment outcome than poor tumescence.

The treatment of secondary orgasmic dysfunction II.

This study investigated the impact of group treatment on women with secondary orgasmic dysfunction and their partners. Eleven couples received 4 hours of basic sex education, after which seven of the couples received a Combination treatment format consisting of communication skills followed by sexual skills, while four of the couples received the opposite sequence. No significant differences were found between the two sequences. When compared with similarly recruited control couples in a previous study, a significantly greater number of treated women reached or exceeded the 50% criterion for coital orgasmic functioning after treatment. Couples who reported a better relationship adjustment prior to treatment reported a significantly greater gain in total sexual harmony than did less adjusted couples. Across the treatment conditions, women who had reached coital orgasm prior to treatment reported a significantly greater increase in relationship adjustment between the post-sex education and 6-month follow-up testing periods than women who had never reached coital orgasm. Some discrepancies in outcome were found in comparison with our earlier study, suggesting that subject heterogeneity may influence differential outcomes.

Treatment of secondary orgasmic dysfunction: an outcome study.

This study investigated the differential effectiveness of various treatment formats for 55 couples in which the woman reported secondary orgasmic dysfunction (defined as the inability of the woman to reach orgasm during intercourse, with or without clitoral stimulation, more than 50% of the time for the last 5 months). Couples received two 2-hr sessions of sexual reeducation and were then assigned into one of four treatment conditions (a communication skills format, a sexual skills format, one of two combination formats) or into one of two control conditions (an attention-comparison control condition which consisted of didactic presentations, or a waiting-list control condition). Treatment was conducted by one of two female clinical psychologists in groups of between four to six couples. No significant differences were found between the different treatment conditions at the posttest or at the 6-month follow-up. Statistical comparisons conducted between the combined treatment and combined control conditions showed that the couples who received treatment reported significantly less overall sexual dissatisfaction and significantly greater sexual harmony at the posttest; however, these differences became nonsignificant at the follow-up. In comparison with the women in the control conditions, a significantly greater number of women who received treatment reached or exceeded the project's 50% criterion for coital orgasmic functioning at the posttest; however, these differences became nonsignificant at the follow-up. Couples who reported less relationship adjustment prior to treatment showed greater overall gains in coital orgasmic frequency than couples who reported better relationship adjustment.

Perspectives of sex therapy outcome: a survey of AASECT providers.

Randomly selected AASECT members who reported that they conduct sex therapy (N = 289) responded to a questionnaire about their sex therapy caseloads. Desire discrepancies between partners was the most common problem (31%). Least commonly reported problems were vaginismus (5%), ejaculatory inhibition (5%), and primary erectile dysfunction (2%). Highest success rates (client satisfaction with sexual functioning) were for premature ejaculation (62%), secondary orgasmic dysfunction (56%), and desire discrepancies (53%). Primary erectile dysfunctions had the lowest success rate (25%). The most commonly used treatment methods were a focus on communication skills, general sex education, homework assignments, and a focus on the sexual interaction; sensate focus, and the discussion of nonsexual individual and/or relationship issues also were quite commonly used. From a discriminant function analysis, the combined Therapists and Multiple-certified provider groups reported focusing on sexual interactions more than the combined Counselors and Educators; the Educators were the least likely providers to use a focus either on sexual interactions or on homework assignments. The Counselors were the most likely, and the Educators the least likely, to use communication skills. Therapists and the Multiple-certified providers estimated higher treatment success rates than Counselors and Educators for premature ejaculation, secondary erectile dysfunction, vaginismus, primary orgasmic dysfunction, sexual avoidance, ejaculatory inhibition, and sexual arousal problems. The Educators were the least successful with dyspareunia. Educators and Counselors were similar in reporting the fewest clients with sexual arousal problems. Therapists and Multiple-certified providers reported spending more treatment hours with desire discrepancies and desire problems. The implications of the findings for clinical practitioners and researchers are discussed.

The sexual interaction of women with secondary orgasmic dysfunction and their partners.

This paper reports the sexual interaction of 48 couples in which the women had secondary orgasmic dysfunction and the men reported no difficulties in sexual functioning. The results were contrasted with a sample of 63 "sexually satisfied" couples. On the Sexual Interaction Inventory, male and female members of the dysfunctional couples reported greater dissatisfaction with the frequency and range of specific sexual activities engaged in than their counterparts in the normative sample. Males in the dysfunctional group rated their sexual pleasure slightly higher than the norm, whereas the dysfunctional females' ratings were below average on this dimension. Within the dysfunctional group, males reported low self-acceptance and mate acceptance, while the females were less accepting of themselves but more accepting of their mates' responsivity. The female members of the dysfunctional couples had an average knowledge of their partners' sexual preferences, whereas the males were less accurate than the normative group in their perceptions of their partners' sexual preferences. As expected, the dysfunctional group reported greater overall disharmony and dissatisfaction in their sexual interaction. Implications of these findings for future research are discussed.

Effects of sex education on sexual guilt, anxiety, and attitudes: a comparison of instruction formats.

Previous sex education research has neglected to examine systematically the effects of different types of instruction formats. In the present study, 193 undergraduates were assigned to one of the following conditions: (1) lecture only; (2) small group discussion only; (3) lecture + small group discussion; (4) lecture + extra lecture/review; and (5) no intervention control. Pre- and posttest measures assessed the dimensions of sexual guilt, sexual attitudes, and sexual anxiety. Results revealed significantly greater reductions in sexual guilt for the lecture only, lecture + small group discussion, and lecture + extra lecture/review conditions than for the no intervention control condition. Significantly greater changes in the direction of more tolerant sexual attitudes were found for the small group discussion only and lecture + extra lecture/review conditions than for the no intervention control condition. No other significant results were found. Contrary to expectation, the addition of 9 hours of small group discussion to a semester-long lecture format course did not result in significantly greater positive changes on the dimensions assessed than those achieved by lecture alone. The implications of these findings for the design of sex education courses are discussed. Recommendations for future research include assessment of the long-term effects of sex education on dimensions such as quality of sexual adjustment and consistency of contraceptive usage.

Sexual orientation and sex role conformity.

Homosexuals are stereotypically viewed as deviating from the conventional sex role standards of our society. Homosexual males are regarded as effeminate, while homosexual females are seen as masculine. Some limited empirical support for these stereotypes has been reported in the literature. However, results remain inconclusive. In order to provide a further test of these stereotypes, 186 male and female homosexual, bisexual, and heterosexual subjects were administered the Bem Sex Role Inventory. Results showed no significant support for prevailing stereotypes. Possible reasons for the discrepancy between these findings and previous reports are explored and suggestions are offered for future research.

Comarital sexual behavior: individual and relationship variables.

This study contrasted the individual and relationship variables of 35 married couples who engage in comarital sexual behavior with 35 married couples who do not. The couples were matched on age, length of marriage, age difference between partners, marital satisfaction, and socioeconomic status. Each couple was administered a battery of personality and relationship measures. In comparison with control subjects, comarital subjects reported a higher need for social approval and more liberal attitudes toward heterosexual behavior. Comarital subjects also reported greater sexual satisfaction and pleasure from their sexual relationship. Comarital couples resolved conflicts less satisfactorily than the control couples; the comarital couples disagreed and interrupted more often and used problem-solving strategies less successfully. Future research should explore the characteristics of couples who engage in different forms of recreational sexual activities.

The effects of sex education on women with secondary orgasmic dysfunction.

This study evaluated the effects of sex education on 48 couples in which the women reported secondary orgasmic dysfunction. None of the males had a problem with premature ejaculation or with erectile dysfunction. Couples received two, two-hour sessions of sex education during a one-week period. From measures administered before and after treatment, the women reported significantly increased orgasmic frequency and decreased sexual anxiety. The males reported a significant increase in the duration of intercourse and in oral-genital sexual stimulation. None of the subject characteristics significantly predicted overall change. The findings underscored the important role of sex education in facilitating positive changes in a woman's orgasmic frequency and in a sexual relationship. Future research should assess the relative meaningfulness of the various components of the sex education package.

Group treatment of sexual dysfunctions: a methodological review of the outcome literature.

This paper reviewed 36 studies which examined the effects of the group format in the treatment of sexual dysfunctions. The methodological evaluation was conducted within the following sections: subjects, therapists, treatment goals, group composition, time format, treatment, outcome measures and assessment times. Numerous methodological deficiencies were found, most notably the inadequate definitions of dysfunction and treatment success, the failure to control for therapist or expectancy factors, the failure to isolate the specific effects of different treatments, and an absence of control or comparison groups. The data tentatively suggest that a group format is effective in the treatment of female orgasmic dysfunction and secondary erectile dysfunction. Same-sex only groups and couples' groups promote comparable improvements. It is premature to make any conclusive statements regarding the relative efficacy of group and individual treatment formats. Future investigators should examine the specific and relative effects of the various treatment components and explore the potential therapeutic advantages of the group in the treatment of sexual dysfunction.

Sex education: a review of its effects.

This paper reviewed 33 empirical studies which assessed the effectiveness of sex education. Methodological issues were considered within six sections: (a) populations, (b) instructors, (c) program formats, (d) time format, (e) program goals, and (f) outcome measures. College students were the most frequently assessed population, followed by educators and counselors, and then medical-school populations. Most investigators did not include control subjects. In the studies which included them, they were usually nonequivalent to the experimental subjects. The results were almost exclusively dependent upon questionnaire data. Only a few studies included a follow-up. In general, the subjects reported gains in sexual knowledge and shifts toward more tolerant and liberal sexual attitudes. However, it was not clear whether or to what extent these changes affected the subjects' behavior. The surprising lack of studies evaluating the effects of sex education on elementary, junior high, and high school students was noted in light of the controversy surrounding the presentation of sex-related information to these populations. In addition to the recommendation that sex education presented to "normal" students who are below the college level should be evaluated, suggestions for future research included the use of equivalent experimental and control subjects, the reporting of instructor characteristics, the specification of program goals, and the inclusion of follow-up evaluations.

Treatments of premature ejaculation and psychogenic impotence: a critical review of the literature.

Research on the treatments of premature ejaculation and psychogenic impotence is reviewed. Problems with the existing definitions of these disorders are discussed. The studies are reviewed under seven major headings: depth therapies, behavior therapies, hypnosis, drug therapy, mechanotherapy, reeducative and supportive therapies, and extensive retraining programs. Most of the studies were case reports. Considerable methodological weaknesses were found, most notably the failure to specify subject and treatment variables, the confounding of treatment methods, inadequate or nonexistent control groups, limited, if any, follow-up assessments of treatment effects, and a failure to obtain partner validation of subjects' progress. The studies which used systematic desensitization and the studies which assessed the extensive retraining programs reported the most consistently positive results, although better-controlled replications are needed. Among other issues, it was suggested that future investigators examine the impact of treatment of homogeneous samples and conduct controlled comparisons of different treatment methods.

Effects of group systematic desensitization on female orgasmic dysfunction.

This study investigated the impact of group systematic desensitization (SD) on varied aspects of sexual functioning in primary and secondary nonorgasmic women. After serving as their own controls, 22 women (eight primary, 14 secondary) received 15 sessions of group SD using four common hierarchies of sexual scenes. The measures were administered to each subject and her regular sex partner at each of the testing periods. Significant positive treatment effects were found on measures of general and specific sexual adjustment and in extracoital orgasmic frequency. Treatment also enhanced sexual communication among subjects and their partners, increased the females' acceptance of their mates as being satisfactory sexual partners, and increased the females' self-acceptance as sexual beings. All but one of the treatment effects (degree of pleasure experienced during extracoital stimulation) were maintained at the 6-week follow-up. Secondary subjects reported significantly greater pleasure from coital and extracoital stimulation and significantly increased frequency of orgasm in response to extracoital stimulation than primary subjects. Primary and secondary subjects did not differ in their evaluation of the experiment. The need for controlled comparative treatment investigations is stressed.