Erick Janssen

The dual control model of male sexual response: a theoretical approach to centrally mediated erectile dysfunction

A theoretical model of dual control of male sexual response is considered, based on the balancing of central excitation and inhibition, with individuals varying in their propensity for both sexual excitation and inhibition of sexual response. A questionnaire method for measuring propensities for sexual excitation and inhibition has been developed (SIS/SES questionnaire), resulting in one excitation factor (SES) and two inhibition factors (SIS1 and SIS2). Evidence for the existence of both inhibitory and excitatory tone is discussed. The first inhibition factor (SIS1) may be related to level of inhibitory tone and is associated with fear of performance failure. The second inhibition factor (SIS2) may be related to external threats (e.g. from within the sexual relationship). The implications for the treatment of centrally mediated erectile dysfunction are discussed, with predictions that high SIS2 individuals will respond to psychological treatment, whereas high SIS1 individuals will respond better to pharmacological methods of treatment.

Automatic processes and the appraisal of sexual stimuli: Toward an information processing model of sexual arousal

A model of sexual arousal is presented that highlights the interaction between automatic and controlled cognitive processes and proposes that different levels of cognitive processing can differentially affect subjective and physiological sexual arousal. In addition, two studies are presented in which the role of automatic processes was explored using a priming paradigm. Subjects were sexually functional men. In the first study an effect of priming was found on penile erection. Unexpectedly, responses were lower in sexual than in neutral trials. In the second study support was found, using a behavioral measure (decision time), for the notion that the meaning of sexual stimuli can be perceived in a fast, automatic manner. Priming was most successful at lower levels of stimulus accessibility. The model and experimental approach presented in this article render starting points for new research on response discordance, gender differences in the processing of sexual stimuli, and inhibition of sexual response.

The Dual Control Model: Current Status and Future Directions

The Dual Control Model proposes that sexual responses involve an interaction between sexual excitatory and sexual inhibitory processes. The model further postulates that individuals vary in their propensity for both sexual excitation and sexual inhibition, and that such variations help us to understand much of the variability in human sexuality. The development of psychometrically validated instruments for measuring such propensities for men (Sexual Inhibition/Sexual Excitation Scales) and for women (Sexual Excitation/Sexual Inhibition Inventory for Women) is described. These measures show close to normal variability in both men and women, supporting the concept that “normal” levels of inhibition proneness are adaptive. The relevance of the model to sexual development, sexual desire, the effects of aging, sexual identity, and the relation between mood and sexuality are discussed, and the available evidence is reviewed. Particular attention is paid to gender differences and similarities in propensities for sexual excitation and inhibition. Research findings related to sexual problems, high-risk sexual behavior, and the relevance of this model to clinical management of such problems are also summarized. Last, ideas for future use and further development of the Dual Control Model are considered.

The Sexual Inhibition (SIS) and Sexual Excitation (SES) Scales: I. Measuring sexual inhibition and excitation proneness in men.

This study involves the development and initial validation of a questionnaire measuring the propensity for sexual inhibition and excitation in men: the Sexual Inhibition & Sexual Excitation Scales (SIS/SES). The underlying theoretical model postulates that sexual response and associated behavior depend on dual control mechanisms, involving excitatory and inhibitory neurophysiological systems. The scales and their discriminant and convergent validity and test‐retest reliability are described. In a sample of 408 sexually functional men (mean age = 22.8 years), factor analyses identified three higher‐level factors: two related to sexual inhibition and one to sexual excitation. Multigroup Confirmatory Factor Analyses revealed that the factor structure provided an acceptable fit to the data obtained in a second (N = 459; mean age = 20.9 years) and third (N = 313; mean age = 46.2 years) sample of men, with similar distributions and relationships with other measures. Theoretical issues and areas for further research, including male sexual dysfunction and risk taking, are discussed.

The Relation Between Mood and Sexuality in Heterosexual Men

This paper reports on a study of individual variability in the relationship between negative mood and sexuality in men. Part 1 involves a questionnaire survey of 919 white heterosexual men, asking what typically happens to sexual interest and response when (a) depressed and (b) anxious/stressed, using the Mood and Sexuality Questionnaire (MSQ). Trait measures of sexual inhibition and excitation, depression, anxiety, and sensation seeking were also used. Relationships between trait measures and MSQ scores were tested using multiple linear and ordinal logistic regression. Of those reporting the experience of depression, 9.4% indicated increased and 42% decreased sexual interest when depressed; for anxiety/stress, the percentages were 20.6 and 28.3%, respectively. Increase in sexual interest during negative mood states was negatively related to age and trait measures of sexual inhibition and positively related to depression proneness and sexual excitation. In Part 2, the relationship between mood and sexuality was explored qualitatively, using in-depth interviews with 43 participants from Part 1. This supported the findings in Part 1, while finding more complex relations with depression than anxiety. Sex when depressed can serve needs for intimacy and self-validation as well as sexual pleasure. Sex when anxious appears to be more simply related to the calming effect of sexual release, plus a possible “excitation transfer” effect of anxious arousal. Further research is needed to explore these relationships in clinical mood disorders. Paradoxical increases of sexual interest with negative mood may help explain high risk as well as “out of control” patterns of sexual behavior.

Selecting Films for Sex Research: Gender Differences in Erotic Film Preference

The aim of this study was to explore gender differences in sexual responsiveness to erotic films that had been selected for their differential appeal for men and women. A secondary objective was to identify variables that influence sexual arousal and explore whether these variables differ for men and women. Fifteen men (M age = 26 yrs) and 17 women (M age = 24 yrs) were presented with 20 film clips depicting heterosexual interactions, half of which were female- and the other half male-selected, and were asked to rate the clips on a number of dimensions. Overall, men found the film clips more sexually arousing than did the women. Gender differences in arousal were negligible for female-selected clips but substantial for male-selected clips. Furthermore, men and women experienced higher levels of sexual arousal to clips selected for individuals of their own gender. Cluster regression analyses, explaining 77% of the variance for male and 65% for female participants, revealed that mens sexual arousal was dependent upon the attractiveness of the female actor, feeling interested, and both “imagining oneself as a participant” and “watching as an observer.” For women, with all variables entered, only “imagining oneself as a participant” contributed to sexual arousal ratings. The findings suggest that how films are selected in sex research is an important variable in predicting levels of sexual arousal reported by men and women.

Sexual Activity and Risk Taking in Young Heterosexual Men: The Relevance of Sexual Arousability, Mood, and Sensation Seeking

In this research we explored three aspects of personality relevant to sexual activity and sexual risk taking in heterosexual men. Men with low inhibition of sexual arousal in the face of risk (low SIS2) reported more partners with whom they use no condoms and more lifetime “one night stands.” Men who experience increased sexual interest in states of depression (MSQ) reported more partners in the past year and more one night stands. The disinhibition subscale of the Sensation Seeking Scale was predictive of whether sexual intercourse had occurred in the past 6 months, and also of the number of sexual partners in the past year. A measure of an intention to practice safer sex was strongly related to measures of sexual arousability and inhibition (SIS/SES). We discuss some clear similarities and also some interesting differences with a parallel study of gay men. Individual differences in sexual excitation and inhibition proneness and the relation between mood and sexuality are clearly relevant to high‐risk sexual behavior and should be taken into consideration when designing behavioral interventions.

The Relation Between Mood and Sexuality in Gay Men

Negative mood, such as depression and anxiety, is usually associated with a decrease in sexual interest and responsiveness. In a minority of individuals, the reverse applies, often with an associated tendency to use sex as a mood regulator. In homosexual men, the prevalence of depression and anxiety states is increased, and the relationship between negative mood and sexuality is, therefore, of particular interest. A new brief instrument, The Mood and Sexuality Questionnaire, was administered to a sample of 662 gay men, with other trait measures of depression and anxiety, propensity for sexual inhibition and sexual excitation, sensation seeking, and questions about sexual activity and response. Sixteen percent reported that, when depressed, they typically experienced increased sexual interest with 7% reporting increased capacity for erectile response; 47% and 37% reported a decrease, respectively; the remainder reported no change. When experiencing anxiety, 24% reported that they typically experienced increased sexual interest, with 14% reporting increased responsiveness, and 39% and 31% reporting a decrease. Forty-three men were interviewed in depth. The resulting qualitative data showed depression to have a more complex relationship to sexual interest than anxiety; other mediating mechanisms, such as need for intimacy and self-validation, were sometimes involved. Fourteen percent of those interviewed reported reduced concern about sexual risk when depressed. Paradoxical increases in sexual interest or activity during negative mood states are relevant to high risk sexual behavior among gay men, and deserve closer study.

The relationship between negative mood and sexuality in heterosexual college women and men

Negative mood states, such as depression and anxiety, are typically associated with decreased sexual interest and arousal. However, there is also some evidence that depressed or anxious mood may increase sexual interest or arousal in some individuals. In this study, 663 female college students (mean age = 18.9 years, SD = 1.21) answered questions regarding the effects of anxious and depressed mood on sexual interest and arousal and completed trait measures of sexual excitation and inhibition, anxiety, and depression. The majority of women reported decreased sexual interest and response when feeling depressed or anxious; a minority (about 10%) of women, however, reported increased sexual interest/response during anxious and depressed mood. This sample of women was compared to a sample of 399 college‐aged men. In general, men were more likely than women to report increased sexual interest during negative mood states. Of the variables explored, propensity for sexual excitation was the strongest predictor of the relationship between negative mood and sexuality in women. Individual differences in the effects of negative mood may prove relevant to our understanding of a variety of topics, including “risky” and “compulsive” sexual behavior and sexual dysfunction.

The sexual inhibition (SIS) and sexual excitation (SES) scales: II. Predicting psychophysiological response patterns

This study evaluated the predictive value of a newly developed measure of the propensity for sexual inhibition and excitation; the Sexual Inhibition & Sexual Excitation Scales (SIS/SES). Sexual, cardiovascular, and startle responses were measured in a group of 40 sexually functional men during the presentation of threatening and nonthreatening erotic films. Two levels of performance demand were created and two films were combined with a distraction task. Participants were assigned to high and low groups for each of the three SIS/SES scales. As predicted, men with high SES scores showed generally higher sexual responses. High and low SIS1 groups did not differ in their responses. Men with high and low SIS2 scores did not differ in their responses to nonthreatening stimuli; however, low SIS2 men showed greater genital response to the threatening stimuli. The findings provide support for the value of the SIS/SES scales in predicting sexual responses.