Stefano Eleuteri

Questionnaires and scales for the evaluation of the online sexual activities: A review of 20 years of research

An increasing number of people use the Internet for Online Sexual Activities (OSA). This sexual revolution has resulted in both positive and negative aspects, enriching sexual functioning but also providing other risks for criminal, negative and harmful sexual conducts, or Online Sexual Problems (OSP). A deeper understanding of Internet sexuality is therefore important for practitioners who work in the psychological and sexological fields. Current studies on Internet sexuality span a broad spectrum with respect to data collection: interviews, questionnaires, observations, content analyses and Internet log file recordings have all been used. The aim of this paper is to offer the most complete overview of these instruments focusing on the strengths and weaknesses of different tools currently available to assess different dimensions of OSA, and to suggest a simple screener for OSP. A systematic search of published online sexual activities inventories was performed using PsychInfo and Pubmed (1993 to July 2013). Although many of them are adequate for their own purposes, our review revealed a lack of standardized, internationally (culturally) accepted tools that are epidemiologically validated in general populations and that can be used to investigate OSA and to assess OSP. The definitions of OSA and OSP continue to change and basic tools are essential to have a broader idea of the phenomenon and of the challenges and possibilities emerging from the double link between the Internet and sexuality. More accurate instruments are also necessary to help advanced clinical diagnosis and treatment for OSP.

Female sexual pain disorders: dyspareunia and vaginismus.

Purpose of review To analyze literature on sexual pain disorders and to review and summarize the articles published throughout 2013 which contribute to the current knowledge on this subject. Recent findings By age 40, 7.8% of women reported vulvar pain. Diagnostic and Statistical Manual of Mental Disorders, fifth edition, has combined vaginismus and dyspareunia into the same diagnostic label. The research reviewed in this article seems to differently point toward two conditions, focusing on different aspects both on the etiological and on the treatment area. Higher levels of partner-perceived self-efficacy and lower levels of partner catastrophizing were associated with less pain intensity in women with entry dyspareunia, independent of womens pain perception and self-efficacy. Alexithymia and fear were found to be important etiological factors in vaginismus. Summary The present findings did not provide clear evidence in support of the superiority of any treatment and highlight the need for randomized, placebo-controlled trials that compare treatments in the future. A lot of work remained to be done to understand such a complex and multifaceted disturbance as genital sexual pain, but the articles examined showed that we are slowly adding more knowledge on the etiological cause and treatment models for such conditions.

Identity, relationships, sexuality, and risky behaviors of adolescents in the context of social media

ABSTRACT The use of social networking services (SNSs) has been reported as one of the favorite activities for adolescents. Over the past decade, SNSs have become some of the most important venues for connecting, communicating, and socializing, as well as identity-building and self-expression. Adolescence is the phase during which individuals construct a critical part in the process of constructing their sexual identity and gender. In the literature, it is suggested that SNSs have become venues for young people to construct and express themselves, and this can produce positive and negative effects. SNSs offer several opportunities for adolescents to explore their sexuality, and cybersex is often the first activity through which teenagers can explore their sexuality freely and without biases. SNS use inevitably affects and is related to adolescents’ sexuality and relationships with peers, sometimes with increasing inclination to risk-taking attitudes and related behaviors. Therefore, our aim of this paper was to explore and address the way in which social media and SNSs are affecting and changing not only adolescent sexuality, but also the type of relationship adolescents establish in their first sexual experiences, including possible risky consequences like cyberbullying, sexting, revenge pornography, excessive use of the Internet, and risky sexual behaviors. Specifically, research will be discussed on the development and evolution of sexuality of adolescents and young adults, also illustrating the clinical consequences.

Delayed ejaculation and alexithymia: what is the relationship?

Delayed Ejaculation (DE) is probably the least studied and understood of the male sexual dysfunctions (MSD). There is still little unanimity concerning its psychological/interpersonal aetiology. Previous studies found that MSD are strongly related with alexithymia, a multifaceted personality construct that describes a disturbance in the regulation of emotions.The aim of this study was to investigate the presence of alexithymia in men with DE and correlate alexithymia levels with DE severity. According to specific features of the symptoms, we hypothesized that alexithymia would not be correlated with this specific sexual disorder. 54 outpatients with a diagnosis of DE assessed at the Institute of Clinical Sexology and the Urology Department of Sapienza, University in Rome were enrolled in the study. DE was diagnosed after a specialist examination and according to Diagnostic and Statistical Manual of Mental Disorders -IV-TR criteria. Participants were provided with the Toronto Alexithymia Scale (20 items; TAS-20), a self-measure of the Intravaginal Ejaculation Latency Time and an ad hoc questionnaire to collect anamnestic data. 9.3% of patients could be categorized as alexithymics, 9.3% of them as borderline, while 81.4% of the sample was found to be non-alexithymic. The overall average TAS-20 score was 45.46. Results show that alexithymia is correlated neither with the presence of DE nor with its severity, in contrast to other MSDs, where this condition was found in about 30% of patients. The data presented suggest that DE, although not correlated to alexithymia, is probably related to other psychogenic features such as hypercontrol configuration. This paper can contribute to the understanding of DE, by excluding one of the possible etiological factors, previously found to be important in the onset and the maintenance of the other MSDs. More studies are needed in order to better understand DE and provide recommendations about treatment.

Is poor sleep associated with obesity in older adults? A narrative review of the literature

IntroductionTo address the worldwide epidemic of obesity, a sizable literature implicates sleep problems in the onset of obesity in younger populations. However, less is known about how this process may operate among older adults, which is of concern, given demographic shifts that have resulted in a much higher proportion of developed nations around the world reaching late life.MethodsWe offer a current review of the literature studying older adults and examining associations between sleep quality and obesity in this population. We consider both subjective and objectively measured sleep as well as both cross-sectional and longitudinal studies offering stronger causal inference.ResultsWe discuss seemingly contradictory literature showing that shorter sleep duration as well as longer sleep duration are associated with obesity risk, then review studies that tested for non-linear relationships and reported a U-shape pattern, suggesting that too much or too little sleep is detrimental. Besides sleep duration, we discuss evidence showing that other forms of sleep dysfunction related to night-time awakenings, REM sleep, slow-wave sleep, and daytime sleepiness, which are indicators of sleep quality, are also linked to obesity. Specific psychological and physiological mediators and moderators, suggesting possible mechanisms whereby sleep problems may affect obesity in older adults, are described.ConclusionWe conclude by discussing areas, where additional research could help clarify this association, considering such factors as medical comorbidities common in late life, and health-related behaviors that may stem from poor sleep (such as disordered eating behavior). Such insights will have great value for clinical practice.Level of evidenceLevel V, narrative review.

The psychological health of patients and their caregivers

Hip-fracture (HF) patients are among the most vulnerable of hospitalised patients. The associated caregiving rehabilitation task often falls to the lot of a member of the patient’s family. Informal caregivers are an important resource for elderly patients suffering from hip fracture because they play a key role during their recovery. A mutual relationship seems to exist between the patient’s psychological well-being and the caregiver’s burden, so that improvements in the state of health of the one boosts that of the other, and vice versa. This datum confirms the importance of using a bio-psycho-social approach when dealing with both patients and caregivers and evaluating the HF patient’s and caregiver’s psychological status. In this chapter we will illustrate why the psychological status of patients and their caregivers is important in the management and outcome of hip fracture, how it should be assessed and how it could be positively influenced by the orthogeriatric team.

Sleep quality as predictor of BMI in non-depressed caregivers of people with dementia

PurposeAlthough most cross-sectional and longitudinal studies of children and adolescents have found a link between short duration of sleep and obesity, the literature related to adults provides a non-consensual framework. The aim of the present study was to examine the association between sleep quality and BMI in a population of caregivers looking after people suffering from dementia, with a view to identifying the moderating role of depressive symptoms in the relationship between sleep problems and BMI.MethodsA total of 117 subjects took part in the study, filling in a Sociodemographic Questionnaire, the Pittsburgh Sleep Quality Index, the Eating behavior Questionnaire and The Center for Epidemiologic Studies-Depression.ResultsDepressive symptoms were greater in females than in males. The sample was divided into two subgroups based on depressive-symptom scores. Only within the subsample with low depressive symptoms, higher sleep disturbances influenced BMI positively. Within this subsample of participants with low depressive symptoms, the variables that seem to play a pivotal role in explaining a high BMI are: female gender, sleep problems, and diet quality, while within the subsample with high depressive symptoms only the female gender factor was found to influence BMI.ConclusionsDepressive symptoms seem to act as moderators in the relationship between sleep and BMI. They should be evaluated to identify the risk of high BMI, and to differentiate clinical intervention, at least in this population, which experiences the stress of caregiving chronically, though not suffering from clinical eating disorders.Level of evidenceLevel II, cross-sectional study.

Attività sessuali online (aso): nuove frontiere e nuovi rischi dell’utilizzo di internet per scopi sessuali

Sempre piu persone utilizzano Internet per attivita sessuali online e il fenomeno e in crescente aumento. Negli ultimi anni, e inoltre emerso un importante doppio legame tra la sessualita e questo nuovo strumento, dove da un lato la tecnologia ha dato un significato diverso ai comportamenti sessuali preesistenti e dall’altro la stessa sessualita ha diretto la costruzione e l’utilizzo di Internet per renderlo sempre piu adatto alle esigenze degli utenti. Questa nuova rivoluzione sessuale ha prodotto aspetti positivi e negativi, costituendo un arricchimento e miglioramento del funzionamento sessuale ma anche un’opportunita ulteriore per condotte criminali, negative e pericolose. Una piu approfondita comprensione della sessualita online risulta dunque importante per coloro che lavorano nel campo psicologico e sessuologico. In questo articolo gli Autori cercano pertanto di offrire una panoramica quanto piu possibile esaustiva di tale fenomeno, delineandone le motivazioni e le possibili conseguenze.

Sexual counselling in elderly couple

The authors will present counselling experiences with elderly couples according to the integrative approach carried out by the “Clinical Institute of Sexology” in Rome. The aim of this presentation is to underline the importance of using sexual counselling as an approach for a psychosexological assessment targeting male and female ageing people. The data that will be introduced concerns elderly couples who have requested sexual counselling from the Institute. The analysis underlines the effectiveness of an approach which combines the classical principles of counselling with the knowledge and the peculiarities of sexological science. In recent years the importance of sexuality has been recognized to be very important non only in the reproductive phase of life but also in the elderly. Sexual counselling serves not only to cure dysfunctions brought on by age, but to help eldery persons continue a healthy sexually active life. Evaluating the numerous physical, psychological and social aspects integrative sexual counselling is to be considered the most suitable approach also to favour an open communication regarding sexuality in this age group.