Gilles Trudel

The effect of a cognitive-behavioral group treatment program on hypoactive sexual desire in women

The present paper describes the first extensive controlled study designed to assess and treat Hypoactive Sexual Desire Disorder (HSD) following an innovative, short-term, cognitive-behavioral group treatment program. HSD is well known to be among the most complex and difficult sexual disorders to treat. While the clinical literature reports positive treatment outcomes and descriptions of successful sex therapy techniques for sexual desire disorders, most of these are based primarily on single or multiple case studies following various therapeutic approaches. To date, there are no comprehensive controlled treatment outcome studies on the effect cognitive-behavioral treatment has on HSD. Results of this study are presented, as well as some descriptive information on women presenting with HSD. In general, results indicate that the treatment protocol is effective. It not only decreases the symptoms of this sexual disorder, but also improves overall cognitive, behavioral and marital functioning associated with HSD.

Sexuality and Marital Life: Results of a Survey

This article presents the results of a telephone survey regarding the conjugal and sex life of men and women from the Montreal region. Surprising as it may seem, the relationship between sexual and marital functioning within the couple has been the focus of little study to date. In fact, relatively little is known about the relationship among sexual behavior, sexual attitudes, sexual fantasies, and marital functioning. In this survey, a questionnaire covering these four variables was administered to 996 subjects chosen at random. The results indicate that women seem to have a more positive perception of their sexual behavior, whereas men seem to have a more positive perception of their marital life. Multiple regression analyses were run to examine the relationship between marital functioning and items related to sexual functioning. The links between sexual satisfaction and other items of the questionnaire concerning sexual behavior, sexual attitudes, and sexual fantasies were also analyzed. For this purpose, we subdivided the subjects into two age groups (under 60 and 60 and over) based on the loss of interest in sexual activity that the questionnaire allowed to discern in the 60+ group. The relationship between marital functioning and items related to sexual behavior proved statistically significant. Various items pertaining to sexual functioning also proved to be related to a global assessment of sexual satisfaction. Cognitive variables (sexual attitudes and sexual fantasies) were found to influence sexual satisfaction but had a lesser impact on marital functioning. Gender and age (under 60 or 60 and over) also had an effect on these relationships.

Effects of a new functional-sexological treatment for premature ejaculation

Premature ejaculation is the most-prevalent sexual problem in men. Various treatments have been developed to increase control over the moment of ejaculation, with two of the most frequent techniques used in behavior therapy being the squeeze method developed by Masters and Johnson (1970) and the “stop-and-start” technique described by Semans (1956). These treatments are effective and improve matters in most cases. However, couples can be averse to using them, with some women reluctant to squeeze their partners penis and some couples unwilling to interrupt sexual interaction once initiated. Under a new functional-sexological treatment intended to improve control over the moment of ejaculation, men learn how to control their arousal without having to interrupt sexual activity. In this study, we compared three groups of couples in which the man suffered from premature ejaculation. One followed the new functional-sexological treatment, another followed a behavioral treatment—including the squeeze and stop-and-start techniques—and a control group was placed on a waiting list. We used several questionnaires to assess the effects of the various treatments. Moreover, subjects provided an objective measure of duration of intercourse from penetration to ejaculation. These measures were taken pre- and posttreatment and at three-month follow-up. We ran analyses of variance to assess the effects of the treatments. Results indicate that the new treatment is very effective. We observed significant improvements in duration of intercourse, sexual satisfaction, and sexual functioning. The subjects in the behavioral treatment group obtained similar results. Furthermore, subjects from both groups were satisfied with their respective treatment.

Marital and sexual aspects of old age

This article presents a review of the literature on conjugal and sexual functioning in elderly people. A synthesis of aging effects on the physiology of sexuality is first presented. The impact of aging on the appearance of sexual dysfunctions is also discussed. Psychological factors, which also play a role in the impact of aging on sexual functioning, are presented. Special attention is paid to the impact of attitudes on sexuality in the course of aging. The question concerning conjugal functioning during retirement is also presented. Different points of view and research results on conjugal satisfaction during retirement are presented. Finally, some studies on intervention methods aimed at the improvement of conjugal and sexual functioning during retirement are presented. In general, we suggest that such interventions would have an impact on the life of elderly people given that, during retirement, conjugal functioning becomes the main focus of peoples life.

Low sexual desire: The role of anxiety, depression and marital adjustment

Abstract Many clinicians presently recognize that low sexual desire (LSD) is an extremely complex problem to evaluate and treat. Several hypotheses have been developed to explain the characteristics of subjects presenting LSD. In the present research a comparison was done between subjects with and without LSD. The results indicate that subjects with LSD have problems with marital adjustment and present a moderate level of anxiety and a low level of depression.

Treatment of Premature Ejaculation by Bibliotherapy: An experimental study

Abstract In this research, bibliotherapy combined with a positive reinforcement procedure was applied to the treatment of premature ejaculation. The results indicate that it is possible to obtain significant improvement in ejaculatory latency by using only a self-administered treatment. Moreover, this study indicates that this improvement is identical to the one obtained when therapists conduct the treatment. Although more subjects treated by bibliotherapy quit the treatment, bibliotherapy was very useful

Dyadic Adjustment in Couples with Hypoactive Sexual Desire

Hypoactive sexual desire (HSD) is a complex sexual problem that has been related to many etiological factors. Marital distress has been frequently mentioned as an important factor related to HSD. T...

Marital relationship and psychological distress: Its correlates and treatments

Abstract The present review examines the link of marital relationship with depressive and anxiety disorders in adult and older couples. Empirical and descriptive studies from the period 1984 to 2005 are reviewed. Particular emphasis is placed on the role of different treatment modalities and methodological approaches for dealing with co-occurring marital discord and psychological distress. Overall, the literature indicates a strong association of depressive symptoms with marital relationship, being this association of a different nature in adult and older couples. Possible causal pathways of this relationship are discussed. However, the literature about the link between anxiety disorders and marital discord is inconclusive, and its relationship in older couples has not yet been addressed. Suggestions for future research are included.

Review of psychological factors in low sexual desire

Abstract During the last decade an increasing number of papers have been published on low sexual desire (LSD). The purpose of this paper is to highlight some important issues related to LSD and critically examine what has been reported in the literature. Problems related to assessment and treatment are presented. The author suggests that research is needed on the characteristics of the subjects suffering from LSD to have a better understanding of this complex sexual problem and to develop effective methods of assessment and treatment.

The use of the multiaxial diagnostic system for sexual dysfunctions in the assessment of hypoactive sexual desire

Hypoactive sexual desire disorders (HSD) are currently recognized as one of the most prevalent and difficult sexual disorders to operationally define, evaluate, and treat. At present, no instrument for the diagnostic assessment has yet prevailed. The present study compared two groups of 20 couples with and without desire problems in order to evaluate the diagnostic utility and discriminative power of the Sexual History Form (SHF), a 28-item questionnaire used to classify sexual dysfunctions following the Multiaxial Diagnostic System for Sexual Dysfunctions (MDSSD). Analysis of the SHF revealed couples with desire problems significantly differed on 15 diagnostic items. Eight of these questions corresponded to the 12 SHF items used by the MDSSD to establish desire-phase diagnoses, and six were most predictive of subjects with desire disorders. Although the current data suggest the SHF is a reliable instrument for the assessment of desire disorders, more studies are needed to further substantiate the diagnostic efficacy of this measure.