Use of sexual stimuli in research and clinical settings: expert opinion and recommendations.

Background: Sexual stimuli, such as sexual videos, images, and narratives describing sexual interactions, are one of many tools used by clinicians and researchers to elicit or augment sexual response. Given the wide variability within sexual stimuli and their effects on sexual response, we provide guidance on when and how to use sexual stimuli, selecting sexual stimuli, and standardizing the use and reporting of sexual stimuli in research and clinical practice. Aim: This expert opinion review article discusses standard operating procedures when using sexual stimuli in clinical and research applications, addressing 3 broad areas: settings in which sexual stimuli are used, characteristics and contexts of the stimuli, and practical and ethical considerations when using the stimuli. Methods: This article is based on an expert opinion review of the sexual psychophysiology literature. Results: First, we discuss the settings in which sexual stimuli are typically used and evaluate the ecological validity of each setting. Second, we review the types of sexual stimuli used in sexual response research, including physical characteristics, depicted sexual activity, and context, and the impacts of these characteristics on sexual response. Last, we discuss the practical and ethical considerations that come with the choice and use of sexual stimuli in clinical and research settings. We address potential limitations of certain sexual stimuli, including practical and ethical considerations such as participant vs experimenter choice, diversity and representation, and proper sourcing of sexual stimuli for use in clinical and research applications. Discussions on the future applications of sexual stimuli, such as the use of virtual reality, and ethical considerations in terms of user-generated Internet sexual stimuli are also explored. Conclusion: We provide an expert opinion review of the literature regarding use of sexual stimuli for clinical and research applications and offer best use practices and recommendations.

A Penny for Your (Sexual) Thoughts: Qualitative Analysis of Women's Self-Described Reactions to Sexual and Nonsexual Stimuli.

Women display a wide range of subjective (self-reported), physiological (genital response), and emotional responses to sexual stimuli. Sexual responses are often assessed using quantitative methodologies; qualitative data can corroborate quantitative data and reveal novel information and avenues for discovery for understanding variations in patterns of sexual response. The current study examined women's (n = 148) responses to various sexual and non-sexual stimuli through open-ended, free response thought journals immediately after watching various neutral (nature themed) and sexually explicit video clips (e.g., solitary masturbation, intercourse). A qualitative content analysis of 842 responses was conducted by five independent coders to determine participants' thoughts immediately after viewing stimuli. Prominent themes included: (1) stimulus appraisals; (2) emotional expressions; and (3) self-reflections and disclosures, which further included participants' sexual-self-disclosures; (4) various degrees of sexual arousal (or lack thereof); and (5) sexual and non-sexual desires. Additional analyses include frequencies and comparisons of specific themes between stimulus types. Findings contribute to understanding cognitive and emotional components of sexual response.

Depression symptoms and reasons for gambling sequentially mediate the associations between insecure attachment styles and problem gambling.

One of the central pathways to problem gambling (PG) is gambling to cope with negative moods, which is a cardinal feature of depression. Insecure attachment styles are also etiologically related to depression; and, therefore, by extension, those who are insecurely attached may engage in excessive gambling behaviors to cope with depression. In this study, we aimed to evaluate this and to this end predicted that depression severity and coping motives for gambling would conjointly mediate the relations between insecure attachment styles and PG. Data came from a larger investigation of PG within mood disorders. Participants exhibited a lifetime depressive or bipolar disorder and endorsed a mood episode within the past ten years. Participants (N=275) completed self-report measures during a two-day assessment. Path analysis supported two main indirect effects. First, anxious attachment predicted elevated depression, which in turn predicted increased coping motives for gambling, which subsequently predicted greater PG severity. Second, this double mediational pathway was also observed for avoidant attachment. Results suggest that insecure attachment relates to PG via depressive symptoms and coping-related gambling motives. Mood symptoms and associated gambling motives are malleable and are promising targets of gambling interventions for insecurely attached individuals.