Stephanie Both

Modulation of spinal reflexes by aversive and sexually appetitive stimuli.

In this study, modulation of spinal tendinous (T) reflexes by sexual stimulation was investigated. T reflexes are augmented in states of appetitive and defensive action and modified by differences in arousal intensity. Reflexes were expected to be facilitated by both pleasant (sexual) and unpleasant (anxiety) stimuli. Subjects were exposed to a sexual, an anxiety-inducing, a sexually threatening, and a neutral film excerpt. Genital arousal, emotional experience, subjective action tendencies, and T reflexes were monitored. Self-report and genital data confirmed the affective states as intended. T reflex amplitude significantly increased during viewing of emotionally arousing film excerpts as compared with a neutral film excerpt. T reflexes were facilitated by the sex stimulus to the same extent as by the anxiety and sexual threat stimuli. The results support the view of sexual arousal as an emotional state, generating sex-specific autonomic and general somatic motor system responses, which prepare the organism for action.

Cognitive Behavioral Therapy for Sexual Dysfunctions in Women

Sexual dysfunctions in women are classified into disorders of desire, arousal, orgasm, and pain (including dyspareunia and vaginismus). As the cognitive behavioral treatment (CBT) procedures differ among these sexual disorders, the treatments for each disorder are reviewed separately. The efficacy of CBT differs depending on the specific sexual dysfunction to be treated. It is concluded that only a few CBT treatments for womens sexual dysfunction have yet been empirically investigated in a methodologically sound way and little is known about which of the treatment components are most effective.

Sexual behavior and responsiveness to sexual stimuli following laboratory‐induced sexual arousal

Sexual excitement can be seen as an action disposition. In this study sexual arousal was expected to generate sexual action and to increase interest and responsiveness to sexual stimuli. In two experiments, male and female participants were exposed to a neutral or a sexual film. We measured genital and subjective responses to the film, and sexual behavior following the laboratory visit. In Experiment 2, film exposure was followed by a task in which participants rated the sexual arousability of neutral and sexual pictures. Rating time of the sexual pictures served as an index for sexual interest. Responsiveness to the sexual pictures was measured by modulation of spinal tendinous (T) reflexes. Sexual activity, but not sexual desire, was higher for participants in the sexual film condition than for participants in the neutral condition. Sexual interest and responsiveness to still pictures were not higher for participants in the sexual film condition than for those in the neutral film condition. In addition, men who saw the neutral film showed a greater responsiveness to still pictures than men who saw the sexual film. The results support the view of sexual arousal as an emotional state generating action tendencies and actual sexual behavior.

Dopamine Modulates Reward System Activity During Subconscious Processing of Sexual Stimuli

Dopaminergic medication influences conscious processing of rewarding stimuli, and is associated with impulsive–compulsive behaviors, such as hypersexuality. Previous studies have shown that subconscious subliminal presentation of sexual stimuli activates brain areas known to be part of the ‘reward system’. In this study, it was hypothesized that dopamine modulates activation in key areas of the reward system, such as the nucleus accumbens, during subconscious processing of sexual stimuli. Young healthy males (n=53) were randomly assigned to two experimental groups or a control group, and were administered a dopamine antagonist (haloperidol), a dopamine agonist (levodopa), or placebo. Brain activation was assessed during a backward-masking task with subliminally presented sexual stimuli. Results showed that levodopa significantly enhanced the activation in the nucleus accumbens and dorsal anterior cingulate when subliminal sexual stimuli were shown, whereas haloperidol decreased activations in those areas. Dopamine thus enhances activations in regions thought to regulate ‘wanting’ in response to potentially rewarding sexual stimuli that are not consciously perceived. This running start of the reward system might explain the pull of rewards in individuals with compulsive reward-seeking behaviors such as hypersexuality and patients who receive dopaminergic medication.

Appetitive and Aversive Classical Conditioning of Female Sexual Response

INTRODUCTION There is only limited evidence for appetitive classical conditioning of female sexual response, and to date modulation of female sexual response by aversive conditioning has not been studied. AIM The aim of this article is to study appetitive and aversive classical conditioning of sexual responses in women. MAIN OUTCOME MEASURES Vaginal pulse amplitude was assessed by vaginal photoplethysmography and ratings of affective value were obtained. METHOD Two differential conditioning experiments were conducted. In Experiment 1, on appetitive conditioning, neutral pictures served as conditional stimuli (CSs) and genital vibrotactile stimulation as the unconditional stimulus (US). In Experiment 2, on aversive conditioning, erotic pictures served as CSs and a pain stimulus as US. In both experiments, only one CS (the CS+) was followed by the US during the acquisition phase. Conditioned responses were assessed during the extinction phase. RESULTS In Experiment 1, during the extinction phase, as expected vaginal pulse amplitude was higher in response to the CS+ than during the CS-. Also, the CS+ was rated as marginally more positive than the CS-. In Experiment 2, during the extinction phase, as expected vaginal pulse amplitude was lower in response to the CS+ than during the CS-, and the CS+ was rated as more negative than the CS-. CONCLUSIONS The results provide evidence for appetitive classical conditioning of sexual response in women, and are the first to show attenuation of sexual response in women by aversive conditioning.

Focusing “Hot” or Focusing “Cool”: Attentional Mechanisms in Sexual Arousal in Men and Women

INTRODUCTION Knowledge about the regulation of sexual emotion may add to the understanding of sexual problems such as diminished sexual desire and hypersexuality. AIM To investigate the regulation of sexual arousal by means of attentional focus in healthy sexually functional men and women. METHOD Using a habituation design with attentional strategies, it was investigated whether a focus on hot, emotional information of sexual stimuli would sustain or amplify sexual responses, whereas a focus on cool, cognitive information would weaken sexual responses. MAIN OUTCOME MEASURES Genital response (in women measured by vaginal photoplethysmography assessing vaginal pulse amplitude, and in men measured by mechanical penile strain gauge assessing penile circumference) and subjective report of sexual arousal and absorption. RESULTS Attenuation of sexual feelings by attentional focus was observed, with stronger sexual feelings under the hot focus condition than under the cool focus condition. Also, sexual feelings diminished during repeated erotic stimulation, and increased with the introduction of novel stimulation, indicating habituation and novelty effects. Contrary to the expectations, the hot attentional focus did not preclude habituation of sexual arousal. CONCLUSIONS Attentional focus has substantial regulatory effects on subjective sexual arousal. Taking a participant and emotion-oriented focus rather than a spectator and stimulus-oriented focus while viewing erotic stimuli, enhances feelings of sexual arousal. Implications for the treatment of hypoactive sexual desire, sexual arousal disorder, and hypersexuality are discussed, as well as future directions for studying regulation of sexual emotion.

The role of conditioning, learning and dopamine in sexual behavior: A narrative review of animal and human studies

Many theories of human sexual behavior assume that sexual stimuli obtain arousing properties through associative learning processes. It is widely accepted that classical conditioning contributes to the etiology of both normal and maladaptive human behaviors. Despite the hypothesized importance of basic learning processes in sexual behavior, research on classical conditioning of the sexual response in humans is scarce. In the present paper, animal studies and studies in humans on the role of pavlovian conditioning on sexual responses are reviewed. Animal research shows robust, direct effects of conditioning processes on partner- and place preference. On the contrast, the empirical research with humans in this area is limited and earlier studies within this field are plagued by methodological confounds. Although recent experimental demonstrations of human sexual conditioning are neither numerous nor robust, sexual arousal showed to be conditionable in both men and women. The present paper serves to highlight the major empirical findings and to renew the insight in how stimuli can acquire sexually arousing value. Hereby also related neurobiological processes in reward learning are discussed. Finally, the connections between animal and human research on the conditionability of sexual responses are discussed, and suggestions for future directions in human research are given.

Effect of a Single Dose of Levodopa on Sexual Response in Men and Women

From animal research, there is ample evidence for a facilitating effect of dopamine on sexual behavior. In humans, little experimental research has been conducted on the inter-relation between dopamine and sexual response, even less so in women than in men. We investigated the effect of levodopa (100 mg) on sexual response in men and women following a double-blind, placebo-controlled crossover design. Genital and subjective sexual responses were measured as well as somatic motor system activity by means of Achilles tendon (T) reflex modulation. Genital and subjective sexual arousal were not affected by levodopa. However, the drug increased T reflex magnitude in response to sexual stimulation in men, but not in women. These results support the view that dopamine is involved in the energetic aspects of appetitive sexual behavior in men. The observed gender difference in the effect of levodopa is discussed in the perspective of possible dopamine–steroid interaction.

Simultaneous Measurement of Pelvic Floor Muscle Activity and Vaginal Blood Flow: A Pilot Study

INTRODUCTION Dyspareunia, defined as persistent or recurrent genital pain associated with sexual intercourse, is hypothesized to be related to pelvic floor hyperactivity and to diminished sexual arousal. Empirical research to support these hypotheses is scarce and concentrates mostly on the role of either pelvic floor activity or genital arousal in female dyspareunia. Currently, however, there is no measurement device to assess pelvic floor activity and genital response simultaneously. AIM The aim of this study was to investigate the validity of a new device that enables simultaneous measurement of pelvic floor activity and genital response in women. MAIN OUTCOME MEASURES Genital arousal measured as vaginal pulse amplitude, and vaginal surface electromyogram (EMG). METHOD Thirty sexually functional women participated. To investigate the accuracy of genital response measurement with the adapted photoplethysmograph, and the sensitivity of the device for involuntary changes in pelvic floor activity, vaginal pulse amplitude and vaginal surface EMG were monitored during exposure to emotional, including erotic, films. In addition, vaginal surface EMG was monitored during instructed pelvic floor contractions. RESULTS The genital data obtained during emotional films proved accurate measurement of genital response. EMG values during the emotional films indicated limited sensitivity of the device for small, involuntary changes in pelvic floor activity due to emotional state. The EMG measurements during the instructed pelvic floor contractions proved sensitivity of the new probe to voluntary pelvic floor activity. CONCLUSION It is concluded that following improvement of the sensitivity of the EMG measurement for small, involuntary changes in pelvic floor activity, the device will be a valuable tool in research on superficial dyspareunia.

Ideal female sexual function.

The members of the Consensus Development Panel on Female Sexual Dysfunction are to be commended for the report about their diagnostic deliberations. Female sexual dysfunction is a relatively unexplored area. Scarcity of data from well-executed research precludes evidence-based decisions. The panelists had recourse to turn to their expert knowledge of the field. A disadvantage of this approach is the possible continuation of existing myths about women’s sexuality. No empirical tests support the reported decisions about diagnostic classifications. Although there is ample reference to basic science, the panelists do not show much awareness of their role as social constructionists. The report reminded us of Theo van de Velde’s book Ideal Marriage Its Physiology and Technique (1928). Van de Velde fostered the acceptance of sexual lust for women, but also continued the sexual submission or sexual dependence of women. He proposed, possibly based on the era in which he lived, that women are to be sexually awakened by men. We are afraid that the panelists did not escape from a similar “ideal” in their construction of Hypoactive Sexual Desire. A theoretical approach to women’s sexuality is sadly absent in the report. In both the formulations of the problems associated with currently used diagnostic systems and the explanation of the decisions about diagnostic classification, theoretical considerations are hardly mentioned. The consensus deliberations seem to provoke the flattest kind of empiricism. There are numerous references to quantifiable measures and end-points. However, measurement methods, especially when using self-report data, are as good as the concepts they pretend to quantify.