Management of sexual problems: the approach of mindfulness.

PURPOSE OF REVIEW: During the last 10 years mindfulness has been progressively integrated into protocols for the management of sexual problems. The purpose of this study is to systematize potential benefits of mindfulness in sexual well-being (considering mind, emotion, and body), and to shortly review current applications and effectiveness of mindfulness-based interventions to the treatment of sexual problems. RECENT FINDINGS: The majority of evidence available focuses on women's sexual desire and arousal problems, although there are also preliminary findings for the effectiveness of mindfulness-based interventions in enhancing other components of the sexual response. Relationship issues, sexual pain, sexual abuse, and sexual distress have also revealed to benefit from mindfulness-based interventions. SUMMARY: The practice of mindfulness is a promising clinical approach with encouraging results for women's sexual problems. Further empirical research with different populations and greater methodological rigour is still needed to clarify the effectiveness of mindfulness as a specific component and the mechanisms contributing to therapeutic change.

The Relationship between Sexual Cues and Sexual Desire in Women.

Sexual desire is one of the most studied dimensions of sexual response. There is extensive research on bio-medical, psychosocial, and relationship predictors of desire particularly in women. Despite this accumulated knowledge, there is a lack of studies investigating the ability of sexual cues to predict sexual desire. A sample of 546 heterosexual and premenopausal Portuguese women, aged between 18 and 53 years old, completed a web survey assessing socio-demographic variables, medical conditions, psychopathology, relationship dimensions, sexual cues and sexual desire. Findings from hierarchical regression analyses indicated that sexual cues significantly predict sexual desire. In particular, explicit/arousal cues (ß = .321, p < .001) were the most significant predictor of female sexual desire. Additionally, somatization (ß = .188, p < .001), relationship satisfaction (ß = .159, p < .001), anxiety (ß = -.165, p = .006), and antidepressant medication (ß = -.094, p = .014) were also significant predictors. Results emphasize the strong ability of explicit/arousal cues to predict sexual desire in women above and beyond other known factors. These findings suggest that the assessment of sexual desire problems in women as well as treatment approaches should take into consideration the role of sexual cues and particularly explicit/arousal cues.

Affective and cognitive determinants of women's sexual response to erotica.

INTRODUCTION: The specific cognitive-affective mechanisms involved in the activation and regulation of the subjective and genital components of sexual arousal are not fully understood yet. AIM: The aim of the present study was to investigate the contribution of self-reported thoughts and affect to the prediction of women's subjective and genital responses to erotica. METHODS: Twenty-eight sexually functional women (mean age = 32, SD = 6.29) were presented with sexually explicit and nonexplicit romantic films. Genital responses, subjective sexual arousal, state affect, and self-reported thoughts were assessed. MAIN OUTCOME MEASURES: Vaginal pulse amplitude was measured using a vaginal photoplethysmograph. Subjective sexual arousal, thoughts, and affective responses were assessed through self-report scales. RESULTS: Correlations between subjective and physiological sexual arousal were low (r = -0.05, P > 0.05). Self-reported thoughts and affect were significant predictors of subjective sexual arousal. The strongest single predictor of subjective arousal was sexual arousal thoughts (e.g., "I'm getting excited") (ß = 0.63, P < 0.01). None of the cognitive or affective variables predicted women's genital responses. CONCLUSIONS: Overall, results support the role of cognitive (self-reported thoughts) and affective dimensions in women's subjective sexual arousal to erotica and, consistent with previous findings, suggest that subjective and physiological sexual arousal may be impacted by different processes.

Predictors of men's sexual response to erotic film stimuli: the role of affect and self-reported thoughts.

INTRODUCTION: Both emotions and cognitions seem to play a role in determining sexual arousal. However, no studies to date have tested the effects of self-reported thoughts on subjective sexual arousal and genital response using psychophysiological methods. AIM: The aim of the present study was to evaluate the role of self-reported thoughts and affect during exposure to erotic material in predicting subjective and genital responses in sexually healthy men. METHODS: Twenty-seven men were presented with two explicit films, and genital responses, subjective sexual arousal, self-reported thoughts, and positive and negative affect were assessed. MAIN OUTCOME MEASURES: Men's genital responses, subjective sexual arousal, affective responses, and self-reported thoughts during exposure to sexual stimulus were measured. RESULTS: Regression analyses revealed that genital responses were predicted by self-reported thoughts (explaining 20% of the variance) but not by affect during exposure to erotic films. On the other hand, subjective sexual arousal was significantly predicted by both positive and negative affect (explaining 18% of the variance) and self-reported thoughts (explaining 37% of the variance). Follow-up analyses using the single predictors showed that "sexual arousal thoughts" were the only significant predictor of subjective response (ß = 0.64; P < 0.01) and that "distracting/disengaging thoughts" were the best predictor of genital response (ß = -0.51; P < 0.05). CONCLUSIONS: The findings of this study suggest that both affect and sexual arousal thoughts play an important role in men's subjective sexual response, whereas genital response seems to be better predicted by distracting thoughts.

Gender differences in sexual arousal and affective responses to erotica: the effects of type of film and fantasy instructions.

The present study examined men and women's sexual and affective responses to erotic film clips that were combined with different fantasy instructions. Men (n = 29) and women (n = 28) were presented with two types of erotic films (explicit vs. romantic) and two fantasy instructions (fantasizing about one's real-life partner vs. fantasizing about someone else). Genital response, subjective sexual arousal, and affective responses were assessed. Sexually explicit stimuli resulted in larger genital responses; women reported higher subjective sexual arousal than men; and fantasizing about one's partner resulted, overall, in higher subjective sexual arousal and higher levels of positive affect. Moreover, in women, the instruction to fantasize about one's partner resulted in stronger subjective sexual arousal to the explicit film than the instruction to fantasize about someone else. Results suggested that physiological, subjective, and affective responses to erotic film stimuli are impacted not only by stimulus characteristics but also by the viewer's interpretation of the depicted relationship.