Stewart E. Cooper

Defining premature ejaculation for experimental and clinical investigations.

Researchers investigating premature ejaculation (PE) have employed widely diverse definitions of it, thereby limiting progress in the field. This study summarizes available research on PE, notes patterns that emerge from these studies, compares patterns across several types of studies, and suggests a common model for defining PE groups to guide future research. We surveyed two bibliographic databases, identifying 45 studies employing a definition or description of a PE group. From these, we extracted a range of information, including descriptions of the participants, recruitment procedures, if PE subtypes were identified, operational criteria for PE classification, relationship and partner information, and additional inclusion/exclusion criteria. Over 50% of studies reported no criteria, or relied on simple self-identification by participants to establish the PE group. Quantifiable behavioral criteria were used in 49% of the studies, with ejaculatory latency reported most frequently. This measure was also used as a criterion more frequently in studies focusing on assessment of sexual response, whereas the number of penile thrusts was used more frequently in studies prior to 1989. Partner information was often included but seldom used as part of the assessment procedure. Progress on research and treatment of PE will continue to be limited by the absence of commonly accepted criteria for PE group membership and by a lack of identification of relevant PE subtypes and etiologies. This paper suggests a flowchart, based on data and a rational analysis of 40 years of research, for characterizing PE in ways that could assist the development of the field.

Genital and psychoaffective response to erotic stimulation in sexually functional and dysfunctional men

To understand the sexual response patterns of men with premature ejaculation and erectile dysfunction, the authors compared genital and affective responses of sexually functional and dysfunctional men with 3 types of sexual stimulation: an erotic video, penile vibrotactile stimulation, and a combination of both. Genital response differed across both groups and stimulus conditions, with an interactive effect indicating that groups showed different response patterns depending on the stimulation. Affective responses also differed across groups and interacted with stimulus conditions. The combination genital and affective response was superior to either alone in distinguishing men with no sexual problems from those with erectile or ejaculatory problems (or both). These factors were particularly useful in discriminating men with premature ejaculation from those with combined premature ejaculation and erectile dysfunction.

The study of ejaculatory response in men in the psychophysiological laboratory

Sexual psychophysiological researchers have had limited success in studying ejaculatory response in the laboratory in men and, more specifically, in identifying factors that differentiate the sexual response of men with premature ejaculation (PE) from controls. A number of methodological limitations may have contributed to the lack of effects in these studies, including lack of stimuli and response measures specific to ejaculatory response. To understand further the sexual response patterns of men with premature ejaculation, penile response, subjective arousal, and subjective and objective measures of pending or actual ejaculation were measured in men with premature ejaculation and controls to two types of stimulation: an erotic video and an erotic video plus penile vibrotactile stimulation. Erectile response differed across stimulus conditions, but not across groups (men with PE versus controls). A number of group, stimulus, and group by stimulus effects were found on subjective measures of arousal, perc...

Communication in a South African Cancer Setting: Cross-Cultural Implications

The purpose of this article is to address cross-cultural provider–patient communication difficulties and their subsequent interference with the quality of treatment. The work currently under way between the Western-trained medical profession and three underserved communities of Black South Africans accustomed to traditional medicine systems serves as the illustrative case. Specifically, in this international project, American psychologists are assisting highly educated, urban Afrikaner medical and health care professionals enhance the cancer treatment provided to rural, low-income Zulu, Tswana, and Pedi patients. This paper consists of several sections. The first section discusses the two cultures involved in the project, with an emphasis on facts about the underserved populations. The second section summarizes findings from the administration of translations of a quality of life instrument (FACT-G). The following section outlines key findings in the area of doctor–patient communication in the Western medical context and specific provider–patient research in South Africa. Communication patterns in medical contexts as influenced by culture as well as doctor–patient relationship expectations are the focus of discussion in the fourth section, and the next section presents related general cross-cultural factors as developed by Geert Hofstede and various multicultural psychology authors. The subsequent section provides additional information from Witte and Morrison on culturally influenced perspectives of health. The final section presents several overall conclusions and recommendations to further improve quality of treatment in cross-cultural contexts.

Graduate Students' Social and Emotional Functioning Relative to Characteristics of Eating Disorders

The authors explored gender-based patterns of relations between social and emotional functioning and the behaviors empirically supported as being highly potent for eating disorders: drive to be thin and body dissatisfaction. Graduate students between 20 and 25 years of age served as participants. Correlation analyses revealed that for women, personal adjustment and internalizing behaviors had significant relations to drive for thinness and body dissatisfaction. Using hierarchical regression analysis, the authors found that self-esteem contributed to the most variation in the prediction of both outcome variables. A differing pattern emerged for men as drive for muscularity and hyperactivity were most strongly predictive of drive for thinness, but not body dissatisfaction. The authors discuss implications relative to T. L. Tylka and L. M. Subichs (2004) model.

Quality of Life of Cancer Patients in Underserved Populations in South Africa

Abstract The majority of studies on the relationship between cancer and well-being have been conducted in the United States and other Western countries. Consequently, a bias might exist that ignores the influence of cultural factors on perceptions of cancer, its etiology, and treatment. This investigation, a pilot study using African languages, attempted to explore the impacts of culture on health-related quality of life by using Cellas FACT-G scales to study rural Zulu, Pedi, and Tswana patients of extremely low socioeconomic status. Results suggest that cultural factors may exert a significant influence on the experience of FACT-G measured quality-of-life issues for cancer patients. Specifically, cultural attitudes toward accepting fate, a high level of trust and deference to healers, and a highly collectivistic orientation surrounding treatment decisions and procedures may have had an impact on the patients scores on all four FACT-G subscales.

INTRODUCTION TO THE SPECIAL ISSUE ON CULTURE, RACE, AND ETHNICITY IN ORGANIZATIONAL CONSULTING PSYCHOLOGY

The need to strongly and directly address issues related to the rapidly changing culture, race, and ethnicity mix of workers, managers, customers, and services recipients in the United States and throughout many parts of the world is now essential. On the macro level, this need is associated with a society in the United States that will soon reach the “tipping point” whereby non-male, non-Anglo, non–Western European culture, race, and ethnicity will have as prominent an effect as has male, Anglo–Western European culture for the past 250 years (Steward, 1996). Moreover, with all the movements that are “flattening our world” in so many ways, such issues are paramount internationally as well (O’Roark, 2002). On the micro level, the increases in cultural, racial, and ethnic diversity rapidly taking place in most U.S. and global organizations and industries, whether profit or non-profit and manufacturing or service oriented, demand significant attention from those practicing consulting psychology if they wish to practice competently and effectively (Hoppe, 1998; Mullin & Cooper, 2002). For the purposes of this special issue, we use the definitions for culture, race, ethnicity, and multiculturalism/diversity from the Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists (American Psychological Association, 2002).

Evidence-Based Practice in Psychology among College Counseling Center Clinicians

ABSTRACT This empirically based study sought to discover factors underlying diverse sources of information used to inform therapy practice, perceived salience of sources of evidence for clinical practice, importance of common factors to therapy efficiency, and beliefs about evidence-based practice, particularly in the form of evidence-supported treatments (ESTs). The investigation also sought to uncover possible relationships between a variety of individually based demographics and institutionally based demographics and their possible relationship to factors underlying these diverse sources of information. A number of interesting findings emerged.

Combining Psychotherapy and Medication for College Students with Severe Psychopathology: A Descriptive Study.

Abstract Given the extensive and increasing use of medications to augment psychotherapy in intervening with college students with more severe psychopathology, the absence of scholarship on this topic is surprising. This article briefly summarizes earlier published pieces on combining counseling with psychotropic treatment in college counseling center settings. It then reports the results of a retrospective, descriptive study of 87 college counseling center clients receiving a combination of psychotherapy and psychiatric medication intervention. Pre-post change psychosocial impairment scores on the Carroll Rating Scale (CRS) were employed as the outcome measure. Most, but not all clients showed significant improvement on this index.

CONSULTING COMPETENTLY IN MULTICULTURAL CONTEXTS

This article presents personalized reactions to the special issue on Culture, Race, and Ethnicity Challenges in Organizational Consulting Psychology. The first part of the article presents the responses of 4 consulting psychologists to 4 questions. The 4 consultants, an African American woman and man and an Anglo American woman and man, were selected based on their experiences in working with consultees and client systems where diversity and multicultural factors mattered. The second part of the article identifies the common themes that emerged from their 4 narratives plus suggestions to assist consultants in better working with consultees and client systems of diverse culture, race, and ethnicity.