Nicole Prause

Sexual desire, not hypersexuality, is related to neurophysiological responses elicited by sexual images

Background Modulation of sexual desires is, in some cases, necessary to avoid inappropriate or illegal sexual behavior (downregulation of sexual desire) or to engage with a romantic partner (upregulation of sexual desire). Some have suggested that those who have difficulty downregulating their sexual desires be diagnosed as having a sexual ‘addiction’. This diagnosis is thought to be associated with sexual urges that feel out of control, high-frequency sexual behavior, consequences due to those behaviors, and poor ability to reduce those behaviors. However, such symptoms also may be better understood as a non-pathological variation of high sexual desire. Hypersexuals are thought to be relatively sexual reward sensitized, but also to have high exposure to visual sexual stimuli. Thus, the direction of neural responsivity to sexual stimuli expected was unclear. If these individuals exhibit habituation, their P300 amplitude to sexual stimuli should be diminished; if they merely have high sexual desire, their P300 amplitude to sexual stimuli should be increased. Neural responsivity to sexual stimuli in a sample of hypersexuals could differentiate these two competing explanations of symptoms. Methods Fifty-two (13 female) individuals who self-identified as having problems regulating their viewing of visual sexual stimuli viewed emotional (pleasant sexual, pleasant-non-sexual, neutral, and unpleasant) photographs while electroencephalography was collected. Results Larger P300 amplitude differences to pleasant sexual stimuli, relative to neutral stimuli, was negatively related to measures of sexual desire, but not related to measures of hypersexuality. Conclusion Implications for understanding hypersexuality as high desire, rather than disordered, are discussed.

Erotica Viewing Effects on Intimate Relationships and Self/Partner Evaluations

Viewing visual sexual stimuli (VSS) has been documented to have both positive (e.g., increased sexual arousal and sexual behaviors) and negative (e.g., higher anxiety, devaluing of partner attractiveness) effects. Excitation transfer and social comparison theories were used to generate hypotheses that could explain these mixed findings. Forty-four monogamous, heterosexual couples viewed erotic, exciting (non-erotic films), and nature films both alone and together. They rated their feelings of general arousal and relationship satisfaction as well as perceptions of self and partner sexual behaviors and attractiveness. Participants viewing both the erotic and exciting films reported equivalent increases in excitement; however, the erotic film was rated as slightly more generally arousing and increased participant’s desire to be close to their partner. Viewing the erotic films also induced greater reports of negative affect, guilt, and anxiety. These findings moderately support a transfer of excitation interpretation. No effects of partner presence or absence while viewing the films was found. Viewing erotic films led to more positive evaluations of one’s own sexual behaviors. These findings provide mixed support in regard to self and partner social comparisons. Co-occurring positive and negative emotional reactions were explored as possible explanation to the complex reactions to VSS.

Viewing Sexual Stimuli Associated with Greater Sexual Responsiveness, Not Erectile Dysfunction

Introduction Time spent viewing visual sexual stimuli (VSS) has the potential to habituate the sexual response and generalize to the partner context. Aim The aim of this study was to examine whether the time spent viewing VSS is related to sexual responsiveness felt in the laboratory or with a sexual partner. Methods Nontreatment-seeking men (N = 280) reported their weekly average VSS viewing in hours. VSS hours were examined in relation to the sexual arousal experienced while viewing a standardized sexual film in the laboratory and erectile problems experienced with a sexual partner. Main Outcome Measures Self-reported sexual arousal in response to sexual films and erectile problems on the International Index of Erectile Function were the main outcome measures. Results More hours viewing VSS was related to stronger experienced sexual responses to VSS in the laboratory, was unrelated to erectile functioning with a partner, and was related to stronger desire for sex with a partner. Conclusions VSS use within the range of hours tested is unlikely to negatively impact sexual functioning, given that responses actually were stronger in those who viewed more VSS.

Frontal alpha asymmetry and sexually motivated states.

Anterior alpha asymmetry of electroencephalographic (EEG) signals has been suggested to index state approach (or avoidance) motivation. This model has not yet been extended to high approach-motivation sexual stimuli, which may represent an important model of reward system function. Sixty-five participants viewed a neutral and a sexually motivating film while their EEG was recorded, and reported their sexual feelings after each film. Greater alpha power in the left hemisphere during sexually motivated states was evident. A positive relationship between self-reported mental sexual arousal and alpha asymmetry was identified, where coherence between these indicators was higher in women. Notably, coherence was stronger when mental versus physical sexual arousal was rated. Alpha asymmetry appears to offer a new method for further examining this novel coherence pattern across men and women.

No Evidence of Emotion Dysregulation in “Hypersexuals” Reporting Their Emotions to a Sexual Film

People who report distress due to their frequent use of visual sexual stimuli (VSS) may experience primarily negative affect, primarily positive affect, or coactivation of positive and negative affect when consuming VSS. Theories of sexual addiction suggest that these individuals regulate their emotions poorly, as evidenced by coactivation of positive and negative emotions during sexual stimulation. Men and women who either reported problems down-regulating their use of VSS (VSS-P, N = 71) or no problem regulating use of VSS (VSS-C, N = 49) watched a neutral film and a sexual film. They reported their positive and negative feelings after each film. Unexpectedly, the VSS-P group exhibited significantly less coactivation of positive and negative affect to the sexual film than VSS-C. This is inconsistent with emotion dysregulation, supposedly a key feature of “hypersexual disorder.” Affect regulation could be failing at a different stage of sexual stimulus processing not studied. Theories about hypersexuality could be more specific regarding when and how affect dysregulation is thought to occur to allow in hypersexuality to allow testing.

Facets of perfectionism in a sample of hypersexual patients.

Abstract This study investigated the role of perfectionism in a treatment-seeking sample (N = 136) of adult men and women using the Perfectionism Inventory (PI) and the Hypersexual Behavior Inventory (HBI). Several facets of perfectionism were positively correlated with hypersexuality, with the concern over mistakes scale from the PI accounting for most of the predictive variance in patterns of hypersexual behavior measured by the HBI. Items associated with concern over mistakes closely parallel the construct of shame noted in other studies of hypersexual patients. To a lesser degree, the PI scale planfulness also showed a negative relationship with hypersexuality, suggesting tendencies of impulsivity in the current patients. These data reinforce the findings in other studies that patterns of harsh self-criticism and impulsivity seem to strongly influence hypersexual behavior.

Functional significance of subjective response to alcohol across levels of alcohol exposure.

Pre‐clinical neurobiological models of addiction etiology including both the allostatic model and incentive sensitization theory suggest that alcohol consumption among alcohol‐dependent (AD) individuals will be dissociated from hedonic reward as positive reinforcement mechanisms wane in later stage dependence. The aims of this study are to test this claim in humans by examining the relationship between dimensions of subjective responses to alcohol (SR) and alcohol craving across levels of alcohol exposure. Non‐treatment‐seeking drinkers (n = 205) completed an i.v. alcohol challenge (final target breath alcohol concentration = 0.06 g/dl) and reported on SR and craving. Participants were classified as light‐to‐moderate drinkers (LMD), heavy drinkers (HD) or AD. Analyses examined group differences in SR and craving response magnitude, as well as concurrent and predictive associations between SR domains and craving. At baseline, LMD and AD reported greater stimulation than HD, which carried over post‐alcohol administration. However, stimulation was dose‐dependently associated with alcohol craving in HD only. Furthermore, lagged models found that stimulation preceded craving among HD only, whereas this hypothesized pattern of results was not observed for craving preceding stimulation. Sedation was also positively associated with craving, yet no group differences were observed. In agreement with the prediction of diminished positive reinforcement in alcohol dependence, this study showed that stimulation/hedonic reward from alcohol did not precede craving in AD, whereas stimulation was dose‐dependently associated with and preceded craving among non‐dependent HD.

Sexual desire, not hypersexuality, predicts self-regulation of sexual arousal

A persons ability to control their own sexual arousal is important both to reduce the risks associated with some sexual behaviours and to respond sexually with intimate partners. A lack of control over sexual urges is a proposed feature of “hypersexual disorder”, though some evidence suggests that sexual desire predicts the self-regulation of sexual arousal better than hypersexuality. In the current study, a sample (N = 116) of men and women recruited from community ads viewed a series of 20-second neutral and sexual films. Before each sexual film, participants were instructed to increase their sexual arousal, decrease their sexual arousal or respond as usual. Higher levels of desire for sex with a partner consistently predicted failures to downregulate sexual arousal. Hypersexuality was unrelated. These findings replicate Winters et al.s study and extend their findings by including upregulation, women, a new measure of hypersexuality and a higher-trial design.

A response to Brody, Costa and Hess (2012): theoretical, statistical and construct problems perpetuated in the study of female orgasm

A string of publications by Brody and colleagues purport to identify health implications in women who report reaching orgasm from vaginal/partnered versus clitoral/solo stimulation. Brody, Costa and Hess (2012) responded to a number of critiques of this line of research, including one by this author (Prause, 2011). Brody, Costa and Hess (2012) elected not to address two of the most critical problems raised: (1) a lack of any theoretical foundation and (2) the absence of psychometric support for their primary measurement. Rebuts are provided for the issues addressed. Also, new data are presented: (1) demonstrating the inadequacy of their methods, (2) falsifying of the vaginal-is-always-optimal prediction, (3) failing to replicate previous reports by Brody and colleagues and (4) documenting confounds of Brody and colleagues measures. Approaches for researchers interested in testing a vaginal-is-always-optimal prediction are suggested in an effort to raise the standards of the science in this area of study.

Women's preferences for penis size: A new research method using selection among 3D models

Women’s preferences for penis size may affect men’s comfort with their own bodies and may have implications for sexual health. Studies of women’s penis size preferences typically have relied on their abstract ratings or selecting amongst 2D, flaccid images. This study used haptic stimuli to allow assessment of women’s size recall accuracy for the first time, as well as examine their preferences for erect penis sizes in different relationship contexts. Women (N = 75) selected amongst 33, 3D models. Women recalled model size accurately using this method, although they made more errors with respect to penis length than circumference. Women preferred a penis of slightly larger circumference and length for one-time (length = 6.4 inches/16.3 cm, circumference = 5.0 inches/12.7 cm) versus long-term (length = 6.3 inches/16.0 cm, circumference = 4.8 inches/12.2 cm) sexual partners. These first estimates of erect penis size preferences using 3D models suggest women accurately recall size and prefer penises only slightly larger than average.