Validation of the multidimensional model of the subjective orgasm experience in the context of same-sex relationships.

Background/objective: The Multidimensional Model of the Subjective Orgasm Experience (MMSOE) has been validated in the context of heterosexual relationships, with no evidence in the context of same-sex relationships. This study aims to examine the association of its dimensions (Affective, Intimacy, Sensory, and Rewards) with the propensity for sexual excitation, rating of sexual arousal, rating of genital sensations, and genital response. Method: Sixty-eight young adults (34 males and 34 females) who were sexually active with people of the same sex participated in a laboratory task in which they viewed content-neutral and sexually explicit gay films. Regression models were conducted to explain the dimensions of MMSOE from measures of sexual arousal. Results: In males, the rating of sexual arousal explained the Sensory dimension, while the genital response explained the Affective dimension, with sexual arousal as a state gaining more prominence. In females, however, the propensity for sexual excitation explained the Sensory dimension, with more salience of sexual arousal as a trait. Conclusions: The MMSOE is shown to be a valid theoretical framework for the study of orgasmic experience in the context of same-sex relationships, with clear implications for clinical practice.

Auditory Cues Alter the Magnitude and Valence of Subjective Sexual Arousal and Desire Induced by an Erotic Video.

Although women and men rate their subjective arousal similarly in response to "female-centric" erotic videos, women rate their subjective arousal lower than men in response to "male-centric" videos, which often end with the male's ejaculation. This study asked whether ratings of subjective sexual arousal and desire using the Sexual Arousal and Desire Inventory (SADI) would be altered if this ending was present or absent, and whether including or excluding the accompanying soundtrack would influence the magnitude and direction of the responses. A total of 119 cis-gendered heterosexual undergraduates (59 women and 60 men) viewed an 11-min sexually explicit heterosexual video that ended with a 15-s ejaculation scene. Two versions of the video were created, one with the ejaculatory ending (E+) and one without (E-). Participants were assigned randomly to view one of the two versions with (S+) or without (S-) the accompanying soundtrack, after which they completed the state version of the SADI. Women and men found both sequences without sound less arousing on the Evaluative, Motivational, and Physiological subscales of the SADI relative to the S+ sequences. However, on the Negative/Aversive subscale, women found the E + S- sequence more negative than did men, whereas this difference was not found with sound. Thus, women and men were sensitive to the auditory content of sexually explicit videos, and scenes of sexual intercourse ending with explicit ejaculation increased the Evaluative and Motivational properties of subjective sexual arousal and desire. However, this occurred in women only when the auditory cues signaled a clear and gratifying sexual interaction.

Study of Sexual Concordance in Men and Women with Different Typologies of Adherence to the Sexual Double Standard / Estudio de la concordancia sexual en hombres y mujeres con diferentes tipologías de adhesión al doble estándar sexual

ResumenAntecedentes/Objetivo: La concordancia sexual (i.e., relación entre respuesta genital y excitación sexual subjetiva) parece ser mayor en hombres que en mujeres. Entre los factores que podrían explicar dicha diferencia estaría el doble estándar sexual (DES). Se examina la concordancia sexual en función de la tipología de adhesión al DES (igualitaria, favorable al hombre y favorable a la mujer). Método: Durante la exposición a un filme de contenido sexual, se registró la respuesta genital (circunferencia peniana/amplitud del pulso vaginal) y la excitación sexual autoinformada de 104 adultos jóvenes (42 hombres y 62 mujeres), distribuidos en las tipologías de adhesión al DES a partir de sus puntuacio-nes en la Sexual Double Standard Scale. Resultados: Se obtuvo concordancia sexual en hombres y mujeres con tipología igualitaria y favorable al hombre. La excitación sexual subjetiva explicó un porcentaje significativo de la varianza de la respuesta genital en la tipología igualitaria (hombres: R2= 0,32, p < 0,01; mujeres: R2= 0,19, p < 0,05) y en la favorable al hombre (hombres: R2= 0,21, p < 0,05; mujeres: R2= 0,23, p < 0,05). Conclu-siones: El acuerdo entre la respuesta genital y la excitación sexual subjetiva depende de la tipología de adhesión al DES.

AbstractBackground/Objective: Sexual concordance (i.e., relationship between genital response and subjective sexual arousal) is higher in men than in women. Among the factors that could explain this difference would be the sexual double standard (SDS). Sexual concordance is examined by SDS typologies of adherence (egalitarian, man-favorable, and woman-favorable). Method: During exposure to a film with sexual content, genital response (penile circumference/vaginal pulse amplitude) and self-reported sexual arousal were recorded in 104 young adults (42 men and 62 women), distributed into SDS typologies of adherence on the basis of their scores on the Sexual Double Standard Scale. Results: Sexual concordance was obtained in men and women with egalitarian and man-favorable typology. Subjective sexual arousal explained a significant percentage of the variance in genital response in the egalitarian typology (men: R2= .32, p < .01; women: R2= .19, p < .05) and man-favorable typology (men: R2= .21, p < .05; women: R2= .23, p < .05). Conclusions: Agreement between genital responsiveness and subjective sexual arousal depends on DES adherence typology.

Study of Sexual Concordance in Men and Women with Different Typologies of Adherence to the Sexual Double Standard.

Background/Objective: Sexual concordance (i.e., relationship between genital response and subjective sexual arousal) is higher in men than in women. Among the factors that could explain this difference would be the sexual double standard (SDS). Sexual concordance is examined by SDS typologies of adherence (egalitarian, man-favorable, and woman-favorable). Method: During exposure to a film with sexual content, genital response (penile circumference/vaginal pulse amplitude) and self-reported sexual arousal were recorded in 104 young adults (42 men and 62 women), distributed into SDS typologies of adherence on the basis of their scores on the Sexual Double Standard Scale. Results: Sexual concordance was obtained in men and women with egalitarian and man-favorable typology. Subjective sexual arousal explained a significant percentage of the variance in genital response in the egalitarian typology (men: R2  = .32, p < .01; women: R2  = .19, p < .05) and man-favorable typology (men: R2  = .21, p < .05; women: R2  = .23, p < .05). Conclusions: Agreement between genital responsiveness and subjective sexual arousal depends on DES adherence typology.

Antecedentes/Objetivo: La concordancia sexual (i.e., relación entre respuesta genital y excitación sexual subjetiva) parece ser mayor en hombres que en mujeres. Entre los factores que podrían explicar dicha diferencia estaría el doble estándar sexual (DES). Se examina la concordancia sexual en función de la tipología de adhesión al DES (igualitaria, favorable al hombre y favorable a la mujer). Método: Durante la exposición a un filme de contenido sexual, se registró la respuesta genital (circunferencia peniana/amplitud del pulso vaginal) y la excitación sexual autoinformada de 104 adultos jóvenes (42 hombres y 62 mujeres), distribuidos en las tipologías de adhesión al DES a partir de sus puntuaciones en la Sexual Double Standard Scale. Resultados: Se obtuvo concordancia sexual en hombres y mujeres con tipología igualitaria y favorable al hombre. La excitación sexual subjetiva explicó un porcentaje significativo de la varianza de la respuesta genital en la tipología igualitaria (hombres: R2  = 0,32, p < 0,01; mujeres: R2  = 0,19, p < 0,05) y en la favorable al hombre (hombres: R2  = 0,21, p < 0,05; mujeres: R2  = 0,23, p < 0,05). Conclusiones: El acuerdo entre la respuesta genital y la excitación sexual subjetiva depende de la tipología de adhesión al DES.

[Connection between subjective sexual arousal and genital response: differences between men and women]. / Relación entre la excitación sexual subjetiva y la respuesta genital: diferencias entre hombres y mujeres.

OBJECTIVE: The level of agreement between subjective and objective measures of sexual arousal is referred as sexual concordance. Sex is one of the principal moderators and there is a higher level of correspondence in men than in women. The aim of this study is to evaluate the predictive validity of the scales Ratings of Sexual Arousal (RSA) and Ratings of Genital Sensations (RGS), relating their scores with the genital response to visual sexual stimuli in men and women. MATERIAL AND METHOD: A sample of 159 young heterosexuals was used (69 men and 90 women) which completed, firstly, a sociodemographic and sexual story questionnaire, the Sexual Inhibition/Sexual Excitation Scales Short-Form and the SOS-6. At the laboratory, they were exposed to a neutral film and to an explicit sexual content film. The subjective sexual arousal was evaluated with the RSA and RGS scales and the genital response was registered through a plethysmography (men) and a photo-plethysmography (women). RESULTS: Significant correlations were obtained between subjective and objective sexual arousal only in men. The RGS scale has the capacity to predict the erection response toward sexual stimuli. CONCLUSIONS: The theory of differences in sexual concordance between men and women was endorsed. Modest evidence about the predictive validity of the subjective sexual arousal evaluation scale was found only in men. It arises the need for subjective and objective assessment of sexual arousal, in clinical settings and research area.

The Mediating Role of Sexual Behavior in Event-Level Associations Between Sexual Difficulties and Sexual Satisfaction in Newlywed Mixed-Sex Couples.

INTRODUCTION: Many sexual difficulties encountered by couples in their day-to-day lives, although of insufficient intensity and persistence to warrant a clinical diagnosis of sexual disorder, are nevertheless frequent and a source of individual and relational distress. AIM: The aim of this study was to assess the event-level associations between couples' everyday, subclinical sexual difficulties (specifically, low subjective sexual arousal, low physiological sexual arousal, and genito-pelvic pain), the range of sexual behaviors that these couples engage in, and their sexual satisfaction. METHODS: 70 Newlywed participants (35 couples, average age = 25.6 years, SD = 3.2 years; average duration of relationship = 5.4 years, SD = 3.4 years) individually completed daily diaries about sexual difficulties, range of activities performed during sex, and sexual satisfaction over the course of 5 weeks. Analyses were guided by the actor-partner interdependence model. MAIN OUTCOME MEASURE: The main outcome was sexual satisfaction, measured at the event-level on a 5-point Likert scale using a single-item question. RESULTS: On days of sexual activity, men and women's difficulties with subjective sexual arousal were associated with lower sexual satisfaction in both partners (actor and partner effects). This association was mediated by the range of couples' sexual behaviors, such that lower subjective arousal was associated with a more restricted range of sexual activities, which in turn was associated with lower sexual satisfaction. Men's and women's difficulties with physiological sexual arousal, and women's genito-pelvic pain, were each associated with their own lower sexual satisfaction. No partner effects were observed for these sexual difficulties, nor were they mediated by the range of couples' sexual activities. CLINICAL IMPLICATIONS: The study's results highlight how couples' sexual difficulties can interfere with same-day sexual satisfaction, and how for subjective sexual arousal, this interference is reflected by a more restricted range of sexual behaviors. STRENGTH & LIMITATIONS: Strengths of the study include the daily diary methodology, which allowed a focus on event-level sexual activities with minimal retrospective bias. Further, the dyadic analyses allowed both intra-individual and inter-individual effects to be assessed. Limitations include the lack of a more general measure of sexual desire and of a more diverse sample, in terms of age, race, and sexual orientation. CONCLUSION: These findings underscore the importance of treatments that include both partners, and that target the types as well as range of sexual activities in which couples engage. Jodouin J-F, Bergeron S, Janssen E. The Mediating Role of Sexual Behavior in Event-Level Associations Between Sexual Difficulties and Sexual Satisfaction in Newlywed Mixed-Sex Couples. J Sex Med 2018;15:1384-1392.

Gender Differences in the Automatic Attention to Romantic Vs Sexually Explicit Stimuli.

INTRODUCTION: Gender differences in sexual responses and cognitive and emotional processing to romantic and sexually explicit stimuli have been reported. However, these differences seem to depend on the automaticity of the task that is being used, thus suggesting that gender differences may be the result of specific mechanisms rather than a generalized effect. AIM: To expand previous basic processes research on gender differences to romantic vs sexually explicit stimuli, focusing on potential differentiating mechanisms influencing male and female sexual responses, we aim to investigate gender differences on automatic attention to sexual stimuli, and to test its relationship with sexual excitation proneness. METHODS: 26 women and 30 men (heterosexual) performed an automatic attention task, in which romantic and sexually explicit stimuli were presented as distractors, that is, stimuli to be ignored, while a concurrent letter discrimination task was performed, followed by a self-report task assessing subjective sexual and emotional responses to the stimuli. MAIN OUTCOME MEASURES: Percentage of accuracy and response times (RTs) to discriminate the target letters were used as markers of automatic attention, with lower accuracy and longer RTs reflecting a higher degree of attentional capture by the distractor stimuli (romantic and sexually explicit). Participants completed self-report ratings on emotional valence, general arousal, and sexual arousal toward romantic and sexually explicit stimuli. They further reported on their sexual excitation proneness. RESULTS: Findings revealed that sexually explicit pictures yielded more automatic attention capture. However, this effect was superseded by pornography consumption, which likely reflects a habituation mechanism. Also, data revealed gender-x type of picture interaction effects only at the self-report task, with men rating sexually explicit stimuli as more sexually exciting, and women rating these stimuli as less pleasant. No relationship was found between automatic attention proxies and sexual excitation proneness. CLINICAL TRANSLATION: While therapeutic strategies are used as tools to improve attention to sexual stimuli (and, hence, increase sexual arousal), the current findings suggest that the specific pathways by which attention influences sexual response are still to be established. Also, gender differences on the subjective appraisal of sex stimuli suggest that therapeutic approaches, consisting on exposure techniques, must recognize gender specificities. STRENGTHS & LIMITATIONS: To our knowledge, this is the first study applying an automatic attention task to the field of sex research, thus adding new inputs to the topic of attention, gender differences, and sexual response. However, there is very limited research in the field of automatic attention, which may limit the interpretation of our findings, at the moment. CONCLUSION: Whereas both genders do not seem to differ in automatic attention toward romantic and sexually explicit stimuli, their responses do differ in their subjective appraisal of the stimuli. Furthermore, despite theoretical assumptions on the relationship between attention and sexual response, automatic attention seemed not to be related to sexual excitation proneness. Carvalho J, Czop O, Rocha M, et al. Gender differences in the automatic attention to romantic vs sexually explicit stimuli. J Sex Med 2018;15:1083-1092.

Understanding Women's Subjective Sexual Arousal Within the Laboratory: Definition, Measurement, and Manipulation.

INTRODUCTION: Subjective sexual arousal (SSA) is positive, cognitive engagement in sexual activity. SSA is considered an important aspect of the sexual experience, as it has been found to facilitate sexual activity and, in situations of chronically low or absent arousal, potentially cause distress. Despite the clinical implications of SSA, a thorough review of how to manipulate SSA has yet to be conducted. AIM: To review the state of knowledge about SSA in women, including its definition, measurement, and the outcomes of studies attempting to manipulate SSA within a laboratory setting. METHOD: A comprehensive search of the electronic databases of PubMed and PsycINFO was conducted. The generated list of articles was reviewed and duplicates were removed. Individual articles were assessed for inclusion and, when appropriate, relevant content was extracted. MAIN OUTCOME MEASURE: The potential effects of various manipulations of SSA in a laboratory setting was the main outcome. RESULTS: 44 studies were included in this review. Manipulations were grouped into 3 primary categories: pharmacological (n = 16), cognitive (n = 22), and those based on changes to the autonomic nervous system (n = 6). Results suggest that cognitive manipulation is the most effective method of increasing SSA. Altering the relative balance of the 2 branches of the autonomic nervous system (the sympathetic nervous system and the parasympathetic nervous system) also appears to be a promising avenue for increasing SSA. CONCLUSION: This review supports the use of cognitive manipulation for increasing women's SSA in a laboratory setting. Avenues for future research and recommendations for clinicians are discussed. Handy AB, Stanton AM, Meston CM. Understanding Women's Subjective Sexual Arousal Within the Laboratory: Definition, Measurement, and Manipulation. Sex Med Rev 2018;6:201-216.

One Session of Autogenic Training Increases Acute Subjective Sexual Arousal in Premenopausal Women Reporting Sexual Arousal Problems.

BACKGROUND: Below average heart rate variability (HRV) has been associated with sexual arousal dysfunction and overall sexual dysfunction in women. Autogenic training, a psychophysiologic relaxation technique, has been shown to increase HRV. In a recent study, sexually healthy women experienced acute increases in physiologic (ie, genital) and subjective sexual arousal after 1 brief session of autogenic training. AIM: To build on these findings by testing the effects of a single session of autogenic training on sexual arousal in a sample of women who reported decreased or absent sexual arousal for at least 6 months. METHODS: Genital sexual arousal, subjective sexual arousal, and perceived genital sensations were assessed in 25 women 20 to 44 years old before and after listening to a 22-minute autogenic training recording. HRV was assessed with electrocardiography. OUTCOMES: Change in genital sexual arousal, subjective sexual arousal, and perceived genital sensations from the pre-manipulation erotic film to the post-manipulation erotic film. RESULTS: Marginally significant increases in discrete subjective sexual arousal (P = .051) and significant increases in perceived genital sensations (P = .018) were observed. In addition, degree of change in HRV significantly moderated increases in subjective arousal measured continuously over time (P < .0001). There were no significant increases in genital arousal after the manipulation. CLINICAL IMPLICATIONS: The results of this study suggest that autogenic training, and other interventions that aim to increase HRV, could be a useful addition to treatment protocols for women who are reporting a lack of subjective arousal or decreased genital sensations. STRENGTHS AND LIMITATIONS: There are few treatment options for women with arousal problems. We report on a new psychosocial intervention that could improve arousal. Limitations include a relatively small sample and the lack of a control group. CONCLUSION: Our findings indicate that autogenic training significantly improves acute subjective arousal and increases perceived genital sensations in premenopausal women with self-reported arousal concerns. Stanton AM, Hixon JG, Nichols LM, Meston CM. One Session of Autogenic Training Increases Acute Subjective Sexual Arousal in Premenopausal Women Reporting Sexual Arousal Problems. J Sex Med 2018;15:64-76.

The Clitoral Photoplethysmograph: A Pilot Study Examining Discriminant and Convergent Validity.

INTRODUCTION: The clitoral photoplethysmograph (CPP) is a relatively new device used to measure changes in clitoral blood volume (CBV); however, its construct validity has not yet been evaluated. AIM: To evaluate the discriminant and convergent validity of the CPP. For discriminant validity, CBV responses should differ between sexual and nonsexual emotional films if the CPP accurately assesses clitoral vasocongestion associated with sexual arousal; for convergent validity, CBV responses should significantly correlate with subjective reports of sexual arousal. METHODS: Twenty women (M age = 21.2 years, SD = 3.4) watched neutral, anxiety-inducing, exhilarating, and sexual (female-male sex) audiovisual stimuli while their genital responses were measured simultaneously using vaginal and clitoral photoplethysmographs and CPPs. Most of these participants continuously reported sexual arousal throughout each stimulus (n = 16), and all reported their sexual and nonsexual affect before and after each stimulus; subjective responses were recorded via button presses using a keypad. MAIN OUTCOME MEASURES: Vaginal pulse amplitude (VPA), CBV, and self-reported sexual arousal and nonsexual affect were used as main outcome measures. RESULTS: CBV demonstrated both discriminant and convergent validity. CBV responses were similar to VPA responses and self-reported sexual arousal; all responses differed significantly as a function of stimulus content, with the sexual stimulus eliciting greater relative changes than nonsexual stimuli. CBV, but not VPA, was significantly (negatively) correlated with continuous self-reported sexual arousal during the shorter sexual stimulus. CBV was significantly negatively correlated with VPA for the shorter sexual stimulus. CONCLUSION: CBV may be a valid measure of women's genital sexual arousal that provides complementary information to VPA and correlates with self-reported sexual arousal. Given our relatively small sample size, and that this is among the first research to use the CPP, the current findings must be replicated. More research using the CPP and other devices is required for a more comprehensive description of women's physiological sexual arousal.

Testing cognitive predictors of individual differences in the sexual psychophysiological responses of sexually functional women.

The literature on sexual responses shows a large and not fully understood between-women variance in sexual responses and in strength of coherence between physiological and subjective sexual responses. This study investigated cognitive factors theorized to be associated with sexual responses that could explain such variance. Specifically, we investigated the predictive value of sexual excitation/inhibition and sexual schemas on sexual response and coherence. Vaginal photoplethysmography and continuous subjective sexual arousal were collected from 29 young women while they watched a control/erotic video sequence. Hierarchical linear modeling revealed that high sexual excitation and schemas related to passion and romance were related to higher coherence. These findings support the notion that cognitive factors that enhance sexual arousal contribute to the large variation seen in the coherence of sexual response as measured in the laboratory.

Gender-specific genital and subjective sexual arousal to prepotent sexual features in heterosexual women and men.

Heterosexual women respond genitally to stimuli featuring both their preferred and nonpreferred genders, whereas men's genital responses are gender-specific, suggesting that gender cues are less relevant to women's sexual response. Instead, prepotent sexual features (exposed and sexually aroused genitals), ubiquitous in audiovisual sexual stimuli, may elicit automatic genital responses, thereby leading to a nonspecific sexual arousal pattern in women. To examine the role of stimulus potency in women's sexual response, we assessed heterosexual women's and men's genital and subjective sexual arousal to slideshows of prepotent stimuli (erect penises and aroused vulvas), non-prepotent stimuli (flaccid penises and female pubic triangles), and sexually neutral stimuli. Contrary to our hypotheses, both women and men demonstrated gender-specific genital and subjective sexual arousal, such that sexual arousal was greatest to prepotent male and female stimuli, respectively. This is the first study to demonstrate gender-specific genital responding in heterosexual women.