Psychological and interpersonal dimensions of sexual function and dysfunction: recommendations from the fifth international consultation on sexual medicine (ICSM 2024).

Introduction: Sexual health concerns are common and significantly impact quality of life, but many people do not seek treatment due to embarrassment and other barriers. A biopsychosocial model of assessment and treatment acknowledges the biological, psychological, and social contributors to sexual difficulties and suggests that all these domains should be evaluated.

Objectives: This paper provides an overview of the major psychological factors contributing to sexual difficulties and offer an evidence-based approach for primary care clinicians to assess and treat these issues.

Psychometric Evaluation and Adaptation of the Five-Factor Sexual Satisfaction Scale (SSS-W) for Use in Men: The Sexual Satisfaction Scale (SSS).

The Sexual Satisfaction Scale for Women (SSS-W) is a psychometrically sound, widely used instrument for assessing sexual satisfaction and distress in women. Because the majority of scale items are gender nonspecific, numerous researchers have adapted this scale for use in male samples. The goal of the current study was to assess the reliability and validity of a slightly modified version of the SSS-W in a male sample ( = 268).

History of Sexual Assault as a Predictor of Response to a Self-Guided Online Program for Sexual Desire and Arousal Difficulties in Women.

Sexual Interest/Arousal Disorder (distressing, long-lasting impairments in sexual desire and/or arousal) is common in women, but few have access to efficacious psychotherapies, including cognitive-behavioral therapy (CBT) and mindfulness-based therapy (MBT). eSense, an online program meant to maximize treatment access, has been shown to be a feasible, satisfactory, and potentially efficacious intervention. However, subpopulations such as sexual assault survivors may find the program less usable or efficacious.

Feasibility of an Online Mindfulness-Based Intervention for Women with Sexual Interest/Arousal Disorder.

Objectives: Difficulties with sexual desire impact up to a third of women and most do not seek or receive appropriate care for these complaints, in part due to stigma, embarrassment, and limited availability of treatment. In-person mindfulness-based interventions have lasting benefits to sexual desire and sex-related distress in controlled clinical trials but are difficult to access. Online cognitive-behavioral interventions for sexual concerns have shown promising findings, but online mindfulness interventions have received little testing.

Feasibility of a cognitive behavioral online intervention for women with Sexual Interest/Arousal Disorder.

Objectives: Difficulties with sexual desire and arousal are common in women, but most lack access to effective treatment such as cognitive-behavioral therapy (CBT). eSense is a recently created online CBT intervention for sexual difficulties with promising evidence of usability. The current study assessed the feasibility of women completing the full eSense CBT program without guidance.

Feasibility of a Brief Online Psychoeducational Intervention for Women With Sexual Interest/Arousal Disorder.

Background: Low sexual desire and arousal are the most common sexual concerns in women, but most women lack access to effective treatment such as cognitive behavioral therapy. Web-based psychological interventions, which are economical, private, easily accessible, and potentially effective, may increase the reach of evidence-based treatment.

Aim: To determine the feasibility of translating cognitive behavioral therapy for the most common female sexual dysfunction, Female Sexual Interest/Arousal Disorder, into an online format.

Statistical Mediators of the Association Between Mindfulness and Sexual Experiences in Men with Impaired Sexual Function.

Mindfulness-based therapy has shown promise as a treatment for female sexual dysfunction and has the potential to be an efficacious treatment for male sexual dysfunction. However, there has been little empirical evidence regarding the mechanisms through which mindfulness may improve sexual experiences, especially for men. Recent theoretical reviews have suggested potential mediators that may explain the beneficial effects of mindfulness on symptoms of male sexual dysfunction, including reduced avoidance of sex, reduced distraction during sex, and/or reduced activation of negative sexual schemas.

Exploring the Role of Sexual Avoidance in Male Sexual Dysfunction.

Theoretical models of male sexual dysfunction highlight the role of sexual avoidance as a maintaining factor. However, little empirical research has directly tested the role of sexual avoidance in samples of men with sexual problems. The goals of the current study were to A) assess the association between sexual avoidance, sexual function, and subjective sexual well-being, and B) explore possible predictors of sexual avoidance, including insecure attachment, activation of negative sexual schemas, and trait experiential avoidance.

Why Is Impaired Sexual Function Distressing to Men? Consequences of Impaired Male Sexual Function and Their Associations With Sexual Well-Being.

Introduction: According to theoretical models of sexual dysfunction, the complex association between male sexual function and subjective sexual well-being (ie, sexual satisfaction and distress) may be partially mediated by specific "consequences" of impaired function, but little research has assessed the frequency of specific consequences or their association with well-being.

Aim: To pilot a scale assessing consequences of impaired male sexual function, and test whether specific consequences (eg, disruption of sexual activity, negative partner responses) mediated the association between sexual function and well-being.

Methods: 166 men in sexually active heterosexual relationships completed self-report measures.

Effects of Mindfulness-Based Therapies for Female Sexual Dysfunction: A Meta-Analytic Review.

Mindfulness-based therapy (MBT) represents a potentially efficacious treatment for female sexual dysfunction (FSD). A number of recent trials assessing MBT for FSD have been published, but we are aware of no existing meta-analysis synthesizing these results. We conducted a literature review to identify all published trials of MBT for FSD.

Statistical and Epistemological Issues in the Evaluation of Treatment Efficacy of Pharmaceutical, Psychological, and Combination Treatments for Women's Sexual Desire Difficulties.

We were grateful to receive responses from Leonore Tiefer, Anita Clayton and Robert Pyke, and Richard Balon and Robert Segraves, to our commentary (Brotto et al., 2016 ) on Pyke and Clayton ( 2015 ). These commentaries raise a number of substantive statistical and epistemological issues relating to the evaluation of treatment efficacy in pharmaceutical, psychological, and combination treatments for sexual desire difficulties and caution researchers to remain mindful of sources of bias as we do the science.

Heterosexual Women's Causal Attributions Regarding Impairment in Sexual Function: Factor Structure and Associations with Well-Being.

Theory and interventions for female sexual dysfunction typically emphasize the role of cognitions, including the perceived causes of impaired sexual function (causal attributions). Although causal attributions have been extensively studied in the context of mood disorders and relational distress, research in the area of sexual dysfunction has been limited. The current study explored the factor structure of women's causal attributions regarding their impaired sexual function and the association between these attributions and multiple indicators of subjective well-being.

Changes in Mindfulness and Posttraumatic Stress Disorder Symptoms Among Veterans Enrolled in Mindfulness-Based Stress Reduction.

Objectives: The current study assessed associations between changes in 5 facets of mindfulness (Acting With Awareness, Observing, Describing, Non-Reactivity, and Nonjudgment) and changes in 4 posttraumatic stress disorder (PTSD) symptom clusters (Re-Experiencing, Avoidance, Emotional Numbing, and Hyperarousal symptoms) among veterans participating in mindfulness-based stress reduction (MBSR).

Method: Secondary analyses were performed with a combined data set consisting of 2 published and 2 unpublished trials of MBSR conducted at a large Veterans Affairs hospital. The combined sample included 113 veterans enrolled in MBSR who screened positive for PTSD and completed measures of mindfulness and PTSD symptoms before and after the 8-week intervention.

Further Validation of the Female Sexual Function Index: Specificity and Associations With Clinical Interview Data.

Female sexual function is a multi-faceted psychophysiological construct. The Female Sexual Function Index (FSFI) is considered a "gold standard" self-report instrument that assesses the various aspects of sexual function. However, researchers have recently proposed potential limitations of the FSFI, highlighting the need for continued validation research.

Why is impaired sexual function distressing to women? The primacy of pleasure in female sexual dysfunction.

Introduction: Recent research has highlighted a complex association between female sexual function and subjective distress regarding sexual activity. These findings are difficult to explain given limited knowledge as to the mechanisms through which impaired sexual function causes distress.

Aim: The current study assessed whether a number of specific consequences of impaired sexual function, including decreased physical pleasure, disruption of sexual activity, and negative partner responses, mediated the association between sexual function and distress.

A pilot trial of telephone-based collaborative care management for PTSD among Iraq/Afghanistan war veterans.

Background: Collaborative care and care management are cornerstones of Primary Care-Mental Health Integration (PC-MHI) and have been shown to reduce depressive symptoms. Historically, the standard of Veterans Affairs (VA) collaborative care was referring patients with posttraumatic stress disorder (PTSD) to specialty care. Although referral to evidence-based specialty care is ideal, many veterans with PTSD do not receive such care.

Assessing the association between childhood sexual abuse and adult sexual experiences in women with sexual difficulties.

Self-report instruments for assessing sexual well-being in women with sexual difficulties have not to date been explicitly validated among women with a history of childhood sexual abuse (CSA). Given an extensive literature suggesting psychological differences between women with and without a history of CSA, it is possible that sexual well-being has a different meaning for these groups. Without validated scales, it is difficult to evaluate the impact of early sexual trauma on adult sexuality.

The conditional importance of sex: exploring the association between sexual well-being and life satisfaction.

Leaders in the field of sexuality have called for additional research examining the link between sexual well-being and life satisfaction in women in order to expand knowledge regarding the important consequences of a satisfying sex life. Participants in the present study were sexually active women reporting a wide range of sexual difficulties who completed an in-person interview, validated self-report measures, and daily online assessments for 4 weeks. Sexual well-being was related to life satisfaction both cross-sectionally and within individuals over time.

Effects of expressive writing on sexual dysfunction, depression, and PTSD in women with a history of childhood sexual abuse: results from a randomized clinical trial.

Introduction: Women with a history of childhood sexual abuse (CSA) have high rates of depression, posttraumatic stress disorder, and sexual problems in adulthood.

Aim: We tested an expressive writing-based intervention for its effects on psychopathology, sexual function, satisfaction, and distress in women who have a history of CSA.

Methods: Seventy women with CSA histories completed five 30-minute sessions of expressive writing, either with a trauma focus or a sexual schema focus.

The young and the restless? Age as a moderator of the association between sexual desire and sexual distress in women.

The authors aimed to assess the degree to which age moderates the association between sexual desire and sexual distress in women. The authors combined 4 independent data sets that yielded a total sample of 771 women (M age = 27.76, SD age = 9.

Relationship satisfaction as a predictor of treatment response during cognitive behavioral sex therapy.

Although recent research suggests that individual cognitive behavioral therapy (CBT) may be an effective treatment for female sexual dysfunctions, we have little information regarding predictors of treatment response. The goal of the current study was to assess the degree to which pre-treatment relationship satisfaction predicted treatment response to cognitive behavioral sex therapy. Women with sexual dysfunction (n = 31, M age = 28 years, 77.

Childhood sexual abuse moderates the association between sexual functioning and sexual distress in women.

Objective: To assess the degree to which a history of childhood sexual abuse (CSA) moderates the association between sexual functioning and sexual distress in women.

Method: Women with (n=105, M age=33.71, 66.

The association between sexual motives and sexual satisfaction: gender differences and categorical comparisons.

Past research suggests that sexual satisfaction may be partially dependent on sexual motives (the reasons people have sex). The primary goal of this study was to determine which of a wide range of empirically derived sexual motives were related to sexual satisfaction, and whether gender differences existed in these relationships. Examining data from 544 undergraduate participants (93 men, 451 women), we found that certain types of motives predicted levels of sexual satisfaction for both genders.

When are sexual difficulties distressing for women? The selective protective value of intimate relationships.

Introduction: Recent studies have shown that sexual functioning and sexually related personal distress are weakly related in women, with only a minority of sexual difficulties resulting in significant levels of distress. However, there has been little systematic research to date on which factors moderate the relationship between sexual functioning and sexual distress.

Aim: To assess the degree to which relational intimacy and attachment anxiety moderate the association between sexual functioning and sexual distress in college-age women.