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.

A comparison of subjective and physiological measures of mechanically produced and erotically produced erections (or, is an erection an erection?).

The current investigation explores possible reasons for the poor overall success rates of medical techniques used in the treatment of erectile dysfunction. This is the first study to compare directly the psychological impact of a mechanically produced versus an erotically produced erection. Subjective and objective parameters of sexual arousal were used to compare the experience of a mechanically attained erection versus an erotically stimulated erection. Twenty-eight (28) men without sexual dysfunction were asked to reach a full erection during each of the following two conditions: (a) by using an ErecAid System and (b) by self-stimulating while watching an erotic video. The results of this study suggest that the penile vacuum device was a successful method for attaining penile tumescence; however, the presence of penile tumescence was not accompanied by a subjective state of physical or mental sexual arousal. Thus, the mere physical presence of an erection does not seem to evoke bodily or mental feelings of sexual arousal. It is important to note that these findings suggest that attention to the psychosexual components of the individual's sexual experience are critical to the subjective experience of sexual arousal and reflect once again the multimodal response systems involved in sexual arousal. These results suggest that more effective treatment approaches would be based on a clinical strategy that provides instruction both on the technical use of a mechanical device as well as on the importance of creating an appropriate psychosexual environment.

Perceived changes in sexual functioning and body image following weight loss in an obese female population: a pilot study.

This study assessed perceived changes in sexual behavior and body image after weight loss in a clinically obese population. Thirty-two women enrolled in a hospital-based multidisciplinary weight management program completed retrospective questionnaires about their sexual functioning and body image before and after weight loss. Subjects reported significant increases in the frequency of their sexual activity. Subjects also perceived significant improvements in their body image. These findings suggest that obese people experience positive changes in sexual functioning and body image after weight loss.

Temperature acquisition as a function of the computer-based biofeedback system utilized: an exploratory analysis.

Thermal biofeedback is widely used to treat various clinical disorders. Given its widespread utility, and the variability among the biofeedback systems currently on the market, it is important to investigate which systems are most effective for training various skills. This study compared the performance of normal subjects on two different computer-biofeedback systems. Results indicated a significant difference in subject performance between the two systems. Limitations and implications of these findings are discussed.

Sexual arousal in diabetic females: physiological and self-report measures.

Diabetes mellitus, a major health problem afflicting 500,000 Americans each year, is a leading cause of male erectile difficulties. Diabetic women may be susceptible to a similar diabetic pathogenesis for sexual problems but information about the effect of diabetes on female sexual response is sparse and conflicting. Past research has been based upon self-report measures, a methodology flawed by susceptibility to response bias. Whether diabetic women differed from a matched nondiabetic control group in their physiological as well as subjective response to erotic stimulus exposures was investigated. Vaginal photoplethysmographic measures of capillary engorgement were taken while subjects individually viewed counterbalanced erotic and non-erotic videotape presentations. Graphically and statistically analyzed results indicated that diabetic women demonstrated significantly less physiological arousal to erotic stimuli than controls, whereas their subjective responses were comparable. These objective, physiological findings support and extend previous subjectively based research which found potential diabetes-related sexual dysfunction in female diabetics. The groups did not differ, however, in the reported occurrence of sexual difficulties.

Volunteer bias in a study of male alcoholics' sexual behavior.

Studies on sexual behavior frequently require that subject volunteers engage in intrusive/sensitive assessment procedures. While earlier investigators have found that these demands may result in volunteer bias (volunteers differing from nonvolunteers), these studies were limited to nonclinical samples. The present study involved 182 males admitted to an inpatient alcoholism rehabilitation program. Those patients who volunteered to participate in an intrusive study examining sexual functioning were dissimilar to nonvolunteers. Compared to nonvolunteers, volunteers reported a greater interest in sex, less satisfaction with sex, more concerns about sexual functioning, a greater incidence of premature ejaculation, and a greater incidence of negative sexual experience. Volunteers also had a higher MAST score, used outpatient substance-abuse counseling more often, and more frequently had a diagnosis of cocaine/amphetamine dependence and cannabis dependence. These differences between volunteers and nonvolunteers suggest a need to use caution when generalizing the results of similar studies to the overall population. Procedures that may help to minimize volunteer bias are offered.

A comparison of nocturnal penile tumescence and penile response to erotic stimulation during waking states in comprehensively diagnosed groups of males experiencing erectile difficulties.

The erectile responses of 13 nondysfunctional males and 48 dysfunctional males were compared during Nocturnal Penile Tumescence (NPT) and during exposure to erotic videotapes. The results showed distinct patterns of NPT and daytime responding that could differentiate the various subgroups: those displaying (i) no dysfunction; (ii) vasculogenic erectile dysfunction; (iii) high risk for erectile dysfunction (organic and psychogenic); (iv) psychogenic dysfunction; reactive to erotica; and (v) psychogenic dysfunction; nonreactive to erotica. Subjects participating in this study underwent a comprehensive medical and psychological screening to place them in each subgroup. The penile circumference response to erotic stimuli used in conjunction with NPT response appeared useful in differentiating subgroups of erectile dysfunction and suggested the need for further diagnostic refinement in this area. The majority of vasculogenic dysfunctional subjects experienced greater erection responses during exposure to erotic stimulation than during NPT; several of these subjects achieved almost full erections in waking states but were practically flaccid at night. The discussion covers diagnostic and therapeutic implications.

Cavernosography in conjunction with artificial erection for evaluation of venous leakage in impotent men.

Twenty men with incomplete penile erection or inability to maintain an erection were evaluated to determine if venous leakage was a cause. Cavernosography was performed in conjunction with artificial erection induced by infusion of saline into the corpus cavernosa. Thirteen patients requiring higher than normal rates of saline infusion to achieve or maintain erection showed filling of superficial veins in the flaccid state as well as during erection. In five of the seven patients with normal saline requirements there was no filling of superficial veins, and two showed filling in the flaccid state only. Of the thirteen patients whose conditions were diagnosed as venous leakage, seven underwent surgical ligation of superficial veins and deep penile vein arterialization by a saphenous vein bypass graft between the superficial femoral artery and deep penile vein. All these patients had reduced saline requirements postoperatively. When cavernosography is performed in the flaccid state only, filling of superficial veins can occur normally; therefore, these studies should be performed with artificial erection.

Effects of medroxyprogesterone acetate on subjective arousal, arousal to erotic stimulation, and nocturnal penile tumescence in male sex offenders.

Three chronic pedophiliac sex offenders were treated individually with medroxyprogesterone acetate (MPA) over a minimum of 3 months. Genital and subjective response to erotic stimulation, nocturnal penile tumescence, self-reporting of sexual urges, and testosterone levels were recorded repeatedly throughout the study. A single-subject reversal design was used and medication was administered through a double-blind procedure. The results showed that self-report of arousal outside of a laboratory setting was unreliable as a measure of the drug effect. In a laboratory setting, however, there appeared to be a significant reduction in the report of arousal to erotic stimuli while genital arousal decreased only slightly. Reversal of these responses occurred in only one subject during a final placebo phase. Nocturnal penile tumescence was significantly decreased during MPA administration and appeared to be related to decreases in total testosterone.

Deep-penile-vein arterialization for arterial and venous impotence.

Eleven impotent men underwent deep-penile-vein arterialization after preoperative assessment by a multidisciplinary team. Penile Doppler pressures, testosterone levels, and nocturnal penile tumescence were used to establish a vasculogenic etiology. Cavernosography, artificial erection by saline infusion, and selective hypogastric arteriography were obtained to delineate whether arterial, venous, or mixed (arterial/venous) factors predominated. Penile revascularization consisted of femoral artery to deep-penile-vein saphenous bypass, with ligation of superficial veins at the base of the penis in patients with venous leakage. Cumulative graft patency was 91% up to 20 months. There were no deaths. The average preoperative flow requirement of values greater than 250 mL/min was reduced to 59 mL/min postoperatively. Follow-up results of nocturnal penile tumescence were excellent in four of four patients with venous (venous leakage), two of three patients with arterial, and one of four patients with mixed factors. Deep-penile-vein arterialization appears to be beneficial for impotence secondary to venous leakage, with inconsistent results for arterial and mixed factors.

A comparison of structural patterns of sexual arousal in male and female homosexuals.

Patterns of sexual arousal were examined for eight male and eight female homosexuals. Comparisons were made in terms of physiological and subjective arousal. The results indicate that for each group there exists very distinct arousal responses, with each group showing the greatest response to same-gender homosexual activity. Results are discussed in relationship to establishing normative data for assessment and clinical function.

A comparison of male and female patterns of sexual arousal.

The structural patterns of sexual arousal are examined for eight male and eight female heterosexuals. Comparisons are made in terms of physiological and subjective arousal. The results indicate (1) that males and females differ in both the direction and magnitude of their arousal response to a variety of erotic stimuli and (2) that there is a stronger correspondence between subjective and physiological measures of sexual arousal for males than for females. A social acceptability and/or unacceptability theory is suggested to account for similarities and differences between the male and female structural patterns of arousal. Several methods of assessing subjective arousal are included to represent those most frequently used in clinical research settings. It is demonstrated that each of the subjective measures discriminates between erotic conditions and that the information provided by each of the measures are comparable.

Effects of demand for performance, self-monitoring of arousal, and increased sympathetic nervous system activity on male erectile response.

Clinical programs for the treatment of impotence generally have been successful but without experimental verification of their individual components or factors associated with the development of impotence. Twenty-four normal males participated in an investigation comparing factors believed to inhibit or facilitate penile tumescence. The effects of demand for performance, self-monitoring of erection, and increased SNS activity, were evaluated. Subjects were exposed to sexual stimuli under these conditions and measurements of penile responses were taken. Results indicated that there were no differential effects on penile responses between demand and no-demand or between self-monitoring and no self-monitoring. Increased SNS activity appeared to facilitate loss of erection, but only after, and not during, the sexual stimulus. The clinical and theoretical implications of these findings are discussed, and suggestions are made for future research.

The effects of a subjective monitoring task in the physiological measure of genital response to erotic stimulation.

Instrumentation has been developed which promises to further our understanding of the relationship between cognitive and physiological factors in the sexual arousal process. Past research has examined this relationship by continuous measurement of genital response, and discrete posttest measurement of subjective arousal. The self-report or "cognitive lever" allows individuals to rate feelings of arousal continuously throughout a stimulus interval by positioning a lever device along a calibrated scale. In this way, structural patterns of physiological and cognitive response can be examined. However, since attention has been shown to be an important cognitive operation in the processing of sexual stimuli, there is concern that this subjective measuring task may confound laboratory assessment by altering genital responsivity through distractive or possibly facilitative mechanisms. In order to test the methodological limitations of the cognitive lever, 14 male and female college students were exposed to duplicate viewings of erotic videotapes while alternately using and not using the self-report device. Results indicated that lever usage was not obtrusive in females, but was in males to the point of altering physiological response. In addition, the study took advantage of the continuous, concurrent measurements and examined patterns of convergence and divergence between the two. Results of correlational analyses indicated, in line with past research, that for men greater degrees of erection result in significantly higher subjective-objective agreement. Patterns for women as a group were much less clear, with only two significant correlations appearing. Finally, the limitations of the cognitive lever were discussed.

Sexual arousal in women: a comparison of cognitive and physiological responses by continuous measurement.

Six sexually normal women were exposed to a wide variety of erotic video tapes while vaginal, groin, and breast vasocongestion measures were tkane. The women indicated their level of sexual arousal while viewing the tapes by positioning a lever device along a calibrated scale. The results indicated highly significant positive correlations among the cognitive and physiological measures for five out of six individual subjects, although the pooled group data failed to show significance. The methodology described in this research shows promise as a diagnostic and research tool.