Causal attributions and male sexual arousal: the impact of attributions for a bogus erectile difficulty on sexual arousal, cognitions, and affect.

After viewing 2 sexually explicit films, 52 sexually functional participants were given bogus feedback indicating a low erectile response. The men were given either an external, fluctuating attribution (i.e., poor films) or an internal, stable attribution (i.e., problematic thoughts about sex) for the low arousal. As hypothesized, participants in the external, fluctuating group evidenced greater erectile response and subjective arousal during a 3rd film than did participants given the internal, stable attribution. This may indicate that after an occasion of erectile difficulty, the cause to which the difficulty is attributed plays an important role in future sexual functioning.

Commonality and specificity of personality disorder profiles in subjects with trauma histories.

Recently, attention has been drawn to a range of disturbances in personality functioning that commonly characterize individuals with a history of severe or prolonged trauma. Many of these features overlap with criteria for some of the Axis II personality disorders. The current study investigated the similarity of personality disorder features in different samples of patients with trauma histories, and specificity of such features compared to other psychiatric samples. Profiles of Axis II features, based on relative frequencies of individual disorder "diagnoses" derived from a common measure (Personality Diagnostic Questionnaire-Revised), were compared in three trauma samples: male Vietnam combat veterans with PTSD, female inpatients with a history of childhood sexual abuse, and female outpatients with a history of childhood sexual abuse. The PDQ-R derived profiles in each of the three trauma samples were then compared with similar PDQ-R derived profiles in published reports of psychiatric samples selected for other diagnoses. Each of the three Spearman rank correlations among the three trauma samples were significant, ranging from .72 to .94. There was a clear pattern of higher correlations within the trauma samples (average correlation of .81) than between the trauma and nontrauma samples (average correlations of .11, .36, and .25 between the nontrauma samples and the combat sample, inpatient sexual abuse sample, and outpatient sexual abuse sample, respectively). The findings suggest that a pattern of personality disorder features may be distinctly associated with individuals with trauma histories, at least of the type examined here. Future studies using more clinically valid measures of personality features and including other types of trauma samples are needed to determine the generalizability of the current findings. Also needed are studies with longitudinal designs to address questions of causal pathways that may underlie such associations.

The conceptual relationship between panic disorder and male erectile dysfunction.

Despite evidence of a relationship between sexual dysfunction and panic disorder, there have been few clinical reports addressing the nature of the association between these phenomena. We present three case reports of men diagnosed with panic disorder with agoraphobia, who presented for treatment of erectile problems. In each of the three cases, the similarity between sensations experienced during sexual arousal and those experienced during panic attacks is noted. The purpose of these case presentations is to stimulate further empirical examination of sex-panic states and to alert practitioners of the possible assessment and treatment implications for such individuals. The symptomatic overlap exhibited in these cases is conceptualized from both a psychobiological model of panic disorder and from Barlow's model of sexual dysfunction in an effort to provide a theoretical framework to guide future research and clinical assessment.

Increasing the incidence of routine pelvic examinations: behavioral medicine's contribution.

Routine gynecological care is important for the maintenance of good health and integral to early detection and treatment of sexually transmitted diseases and cancer. Research indicates that both patients and clinicians find this examination anxiety provoking and, therefore, may fail to comply with optimal guidelines for routine care. Training techniques, effective for attenuating providers' and patients' anxiety, are reviewed. These include medical school programs for providers and seminars on women's health designed for lay people. In addition to providing training when there are fewer immediate stressors, methods for reducing anxiety may be employed proximate to exams. Providing informative, behavioral, and cognitive-behavioral techniques, emphasizing greater patient control, may be useful in decreasing anxiety associated with pelvic examinations. These latter techniques may be incorporated into providers' protocol for routine pelvic examinations and thereby may serve to enhance compliance for routine gynecological care.