Ariel B. Handy

A Pilot Study of Eight-Session Mindfulness-Based Cognitive Therapy Adapted for Women’s Sexual Interest/Arousal Disorder

While few treatment options exist for low sexual desire and arousal, the most common sexual dysfunction in women, a growing body of research supports the efficacy of mindfulness-based approaches. The mechanisms underlying improvements, and whether they are due to mindfulness practice or other treatment components, are unclear. As a result, we designed and pilot-tested an eight-session group mindfulness-based cognitive therapy for sexuality (MBCT-S) program that includes more extensive practice of mindfulness skills and closely aligns with the evidence-based MBCT program for depression and anxiety. A total of 26 women (mean age 43.9, range 25 to 63) with a diagnosis of sexual interest/arousal disorder participated in eight weekly group sessions, before and after which they completed validated questionnaires. The majority of women attended all sessions and completed the recommended at-home mindfulness exercises. Compared to baseline, women reported significant improvements in sexual desire, overall sexual function, and sex-related distress, regardless of treatment expectations, relationship duration, or low desire duration. Depressed mood and mindfulness also significantly improved and mediated increases in sexual function. These pilot data suggest that eight-session MBCT-S is feasible and significantly improves sexual function, and provide the basis for a larger randomized-controlled trial (RCT) with a longer follow-up period.

Interoceptive Awareness Moderates the Relationship Between Perceived and Physiological Genital Arousal in Women.

INTRODUCTION In general, laboratory studies have shown low correlations between subjective (ie, self-report) and physiologic (ie, vaginal pulse amplitude) measurements of sexual arousal in women. One explanation for this presumed low concordance is that women might not be attending to their genital responses and/or might be unable to accurately perceive their genital responses. AIM To examine the extent to which women can perceive their genital arousal sensations, the role that interoceptive awareness plays in this ability, and whether interoceptive awareness influences sexual concordance in women. METHODS Twenty-six sexually functional women viewed an erotic film while their physiologic and perceived genital sexual arousal levels were measured continuously. Self-report measurements of sexual function and bodily awareness also were administered. MAIN OUTCOME MEASURES Physiologic sexual arousal was measured with a vaginal photoplethysmograph, and perception of genital arousal was measured with an arousometer. Degree of bodily awareness was measured with the Multidimensional Assessment of Interoceptive Awareness questionnaire. RESULTS Women exhibited a significant degree of agreement between physiologic and perceived genital arousal (P < .05). Interoceptive awareness was found to significantly moderate this relation (P < 0.05), such that a greater degree of interoceptive awareness facilitated greater agreement between physiologic and perceived genital arousal. Interoceptive awareness also was found to facilitate greater concordance between subjective and physiologic sexual arousal (P < .05). CONCLUSION Women can perceive their genital response, and interoceptive awareness influences this ability and the relation between subjective and physiologic sexual arousal. Increasing bodily awareness could be a plausible route for treatment development.

Sexual function in adolescents and young adults diagnosed with cancer: A systematic review

PurposeThe purpose of this systematic review was to identify, with supporting evidence, the impact of cancer and its treatment on the sexual function of adolescents and young adults.MethodsPubMed, CINAHL, and PsycINFO articles were searched for relevant studies published in English. Fifteen studies, 13 quantitative and two qualitative, were included in this review.ResultsResults indicated that cancer during the adolescent and young adult period has a significant negative impact on certain domains of sexual function in both men and women.ConclusionsAmong adolescent and young adult males, there is evidence that cancer has detrimental effects on erection, ejaculation, and orgasm. Among adolescent and young adult females, cancer is associated with decreased desire, but there appear to be mixed findings with respect to arousal, orgasm, and satisfaction. Directions for future research are discussed.Implications for Cancer SurvivorsA better understanding of the effects of cancer and its treatment during adolescence and young adulthood on sexual function could increase attention paid to sexual health in oncology settings and lead to improved psychosexual services for this population.

Interoception and Awareness of Physiological Sexual Arousal in Women With Sexual Arousal Concerns

ABSTRACT Laboratory studies assessing physiological genital arousal have largely failed to find differences between women with and without female sexual arousal disorder (FSAD). Therefore, it is possible that women with FSAD may be unaware of their genital arousal response. The present study examined the extent to which women with FSAD can report their genital arousal response, as well as the role of interoception (body awareness) in this relationship. Additionally, this study examined the influence of interoception on the relationship between subjective and genital arousal. Twenty-six women who met criteria for FSAD (M age = 29.5, SD = 8.1 years) watched an erotic film and completed a series of questionnaires. Physiological (i.e., genital) and perceived genital arousal were measured continuously throughout the film. Results indicated women were able to perceive their level of physiological arousal. Greater levels of interoception were linked with stronger relationships between perceived and physiological arousal, but not between subjective and genital arousal. Methodological and clinical implications are discussed.

What Does Sexual Arousal Mean to You? Women With and Without Sexual Arousal Concerns Describe Their Experiences

Sexual arousal is frequently characterized by both subjective (i.e., mental) and physiological (e.g., genital) components. The nuances of these components, however, are difficult to capture via self-report instruments. Asking women to describe sexual arousal in their own words may therefore enhance our understanding of this construct. In the present study, women with (n = 190) and without (n = 610) arousal concerns were recruited online and wrote about their experience of sexual arousal. Seven clusters of words were extracted using automated text analysis, and the prominence of these clusters was compared between groups of women. The autonomic arousal cluster differed between groups such that women with arousal concerns invoked this cluster significantly less than did women with no such concerns. Furthermore, the context cluster significantly predicted group membership (odds ratio [OR] = 1.063); greater scores on this cluster were associated with arousal concerns. Results suggest that autonomic arousal and relationship factors may play important roles in arousal concerns. It is suggested that clinicians assess for aspects of the sexual relationship that may facilitate or hinder sexual arousal. Clinicians may also consider inquiring about the presence or appraisal of autonomic arousal (e.g., one’s interpretation of an increase in heart rate or respiration) during sexual activity.